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Question
You are the construction manager for a 20-storey R.C. complex, which is to be used
as a health research centre. The centre also provides health-related facilities like
pharmacy, health consultancy and counseling services. Being a modern complex,
important building services like air conditioning system, water supply system, fire
protection system, security and lighting system, lifts, etc are also provided. You are
to discuss all the important points that need to be considered in order the facilities or
services provide be the new health research centre shall give comfort and efficiency
to all the staff asa well as visitor.
The major factors of finishing the Health Research Centre are safety among
constructions workers, staff, and public. Another major factor is the conformability
of the environment in the centre.
Building Attributes
Regardless of their location, size, or budget, all Health Research Centre should have
certain common attributes.
i. Efficiency and Cost-EffectivenessAn efficient Health Research Centre layout should:
y Promote staff efficiency by minimizing distance of necessary travel betweenfrequently used spaces.
y Allow easy visual supervision of the staff.y Include all needed spaces, but no redundant ones. This requires careful pre-
design programming.
y Provide an efficient logistics system, which might include elevators,pneumatic tubes, box conveyors, manual or automated carts, and gravity or
pneumatic chutes, for the efficient handling of food and clean supplies and
the removal of waste, recyclables, and soiled material
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y Make efficient use of space by locating support spaces so that they may beshared by adjacent functional areas, and by making prudent use of multi-
purpose spaces
yConsolidate visitors functions for more efficient operation on first floor, ifpossible for direct access by visitors
y Group or combine functional areas with similar system requirementsy Provide optimal functional adjacencies, such as locating the surgical
intensive care unit adjacent to the operating suite. These adjacencies should
be based on a detailed functional program which describes the Health
Research Centre's intended operations from the standpoint of patients, staff,
and supplies.
ii. Flexibility and ExpandabilitySince medical needs and modes of treatment will continue to change, Health
Research Centre should:
y Follow modular concepts of space planning and layouty Use generic room sizes and plans as much as possible, rather than highly
specific ones
y Be served by modular, easily accessed, and easily modified mechanical andelectrical systems
y Where size and program allow, be designed on a modular system basis. Thissystem also uses walk-through interstitial space between occupied floors for
mechanical, electrical, and plumbing distribution. For large projects, this
provides continuing adaptability to changing programs and needs, with no
first-cost premium, if properly planned, designed, and bid.
y Be open-ended, with well planned directions for future expansion; forinstance positioning "soft spaces" such as administrative departments,
adjacent to "hard spaces" such as clinical laboratories.
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iii. Therapeutic EnvironmentHealth Research Centre patients are often fearful and confused and these
feelings may impede recovery. Every effort should be made to make the
Health Research Centre stay as unthreatening, comfortable, and stress-free
as possible. The interior designer plays a major role in this effort to create a
therapeutic environment. A Health Research Centre's interior design should
be based on a comprehensive understanding of the facility's mission and its
patient profile. The characteristics of the patient profile will determine the
degree to which the interior design should address aging, loss of visual
acuity, other physical and mental disabilities, and abusiveness. Some
important aspects of creating a therapeutic interior are:
y Using familiar and culturally relevant materials wherever consistent withsanitation and other functional needs
y Using cheerful and varied colors and textures, keeping in mind that somecolors are inappropriate and can interfere with provider assessments of
patients' pallor and skin tones, disorient older or impaired patients, or agitate
patients and staff, particularly some psychiatric patients (for in depth survey
of research related to Color in Healthcare Environments.)
y Admitting ample natural light wherever feasible and using color-correctedlighting in interior spaces which closely approximates natural daylight
y Providing views of the outdoors from every patient bed, and elsewherewherever possible; photo murals of nature scenes are helpful where outdoor
views are not available
y Designing a "way-finding" process into every project.
Patients, visitors, and
staff all need to know where they are, what their destination is, and how to
get there and return. A patient's sense of competence is encouraged by
making spaces easy to find, identify, and use without asking for help.
Building elements, color, texture, and pattern should all give cues, as well as
artwork and signage.
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Cleanliness and Sanitation
Health Research Centre must be easy to clean and maintain. This is facilitated by:
yAppropriate, durable finishes for each functional space
y Careful detailing of such features as doorframes, casework, and finishtransitions to avoid dirt-catching and hard-to-clean crevices and joints
y Adequate and appropriately located housekeeping spacesy Special materials, finishes, and details for spaces which are to be kept
sterile, such as integral cove base. The new antimicrobial surfaces might be
considered for appropriate locations.
Accessibility
All areas, both inside and out, should:
y In addition to meeting minimum requirements of designed so as to be easyto use by the many patients with temporary or permanent handicaps
y Ensuring grades are flat enough to allow easy movement and sidewalks andcorridors are wide enough for two wheelchairs to pass easily
y Ensuring entrance areas are designed to accommodate patients with sloweradaptation rates to dark and light; marking glass walls and doors to make
their presence obvious
Controlled Circulation
A Health Research Centre is a complex system of interrelated functions requiringconstant movement of people and goods. Much of this circulation should be
controlled.
y Outpatients visiting diagnostic and treatment areas should not travel throughinpatient functional areas nor encounter severely ill inpatients
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y Typical outpatient routes should be simple and clearly definedy Visitors should have a simple and direct route to each patient nursing unit
without penetrating other functional areas
y Separate patients and visitors from industrial/logistical areas or floorsy Outflow of trash, recyclables, and soiled materials should be separated from
movement of food and clean supplies, and both should be separated from
routes of patients and visitors
y Transfer of cadavers to and from the morgue should be out of the sight ofpatients and visitors
y Dedicated service elevators for deliveries, food and building maintenanceservices
Aesthetics
Aesthetics is closely related to creating a therapeutic environment (homelike,
attractive.) It is important in enhancing the Health Research Centre's public image
and is thus an important marketing tool. A better environment also contributes to
better staff morale and patient care. Aesthetic considerations include:
y Increased use of natural light, natural materials, and texturesy Use of artworky Attention to proportions, color, scale, and detaily Bright, open, generously-scaled public spacesy Homelike and intimate scale in patient rooms, day rooms, consultation
rooms, and offices
y Compatibility of exterior design with its physical surroundings
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Security and Safety
In addition to the general safety concerns of all buildings, Health Research Centre
have several particular security concerns:
y Protection of Health Research Centre property and assets, including drugsy Protection of patients, including incapacitated patients, and staffy Safe control of violent or unstable patientsy Vulnerability to damage from terrorism because of proximity to high-
vulnerability targets, or because they may be highly visible public buildings
with an important role in the public health system.
Sustainability
Health Research Centres are large public buildings that have a significant impact on
the environment and economy of the surrounding community. They are heavy users
of energy and water and produce large amounts of waste. Because Health Research
Centres place such demands on community resources they are natural candidates for
sustainable design.
Emerging Issues
Among the many new developments and trends influencing Health Research Centre
design are:
y The decreasing numbers of general practitioners along with the increaseduse of emergency facilities for primary care
y The increasing introduction of highly sophisticated diagnostic and treatmenttechnology
y Requirements to remain operational during and after disasters
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y State laws requiring earthquake resistance, both in designing new buildingsand retrofitting existing structures
y New HIPAA (Health Insurance Portability and Accountability Act)regulations address security and privacy of "protected health information"(PHI). These regulations put new emphasis on acoustic and visual privacy
and may affect location and layout of workstations that handle medical
records and other patient information, paper and electronic, as well as
patient accommodations.
y Preventative care versus sickness care; designing Health Research Centresas all-inclusive "wellness centers"
y Use of hand-held computers and portable diagnostic equipment to allowmore mobile, decentralized patient care, and a general shift to computerized
patient information of all kinds. This might require computer alcoves and
data ports in corridors outside patient bedrooms.
y Need to balance increasing attention to building security with openness topatients and visitors
y Emergence of palliative care as a specialty in many major medical centersy A growing interest in more holistic, patient-centered treatment and
environments such as promoted by Plane-tree. This might include providing
mini-medical libraries and computer terminals so patients can research their
conditions and treatments, and locating kitchens and dining areas on
inpatient units so family members can prepare food for patients and families
to eat together.
These are the factors that need to be considering of build a 20 storey HealthResearch Centre Complex to keep the lowers or minimum interruption to the
environment.
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Air Conditioning System
Proper air conditioning is helpful in the prevention and treatment of
diseases. The factors determining the need for air conditioning in Health ResearchCentre facilities are:
y Maintain the indoor air temperature and humidity at comfortable levelsfor staff, patients, and visitors.
y Minimize the risk of transmission of airborne pathogens from infectedpatients.
y Remove contaminated air, (airborne microorganisms, viruses, hazardouschemicals and radioactive substances).
y Facilitate air-handling requirements to protect susceptible staff andpatients from airborne healthcare-associated pathogens.
y Control odors.y The need to restrict air movement within and between various
departments.
y Control the air quality and movement.Temperature
Air conditioning systems in Health Research Centre facilities have either
single-duct (12.8C [55F]) or dual-duct systems.Temperature standards are given
as either a single temperature or a range, depending on the specific zone. Cool
temperature standards (20C -23 C [68F - 73F]) are usually associated with
operating rooms, clean workrooms, and endoscopy suites.
A warmer temperature (24C [75F]) is needed in areas requiring greater degrees of
patient comfort. Most other zones use a temperature range of 21C - 24C (70F -
75F). Temperatures outside of these ranges may be needed on limited occasions in
limited areas depending on individual circumstances during patient care (e.g., cooler
temperatures in operating rooms during specialized operations).
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The important factor is that the air circulation must be contained within each room.
Corridors, nurses stations and serving areas must have a separate supply. Each
room must have an exhaust creating negative pressure. There should be no cross-
communication (contamination) between various areas.
In the design of air conditioning system for laboratory buildings the application of
standard design patterns and practices is very limited. Each laboratory ad building is
a problem in itself that requires the following considerations:
y 24-hours operation of laboratory spaces.y Exact room conditions.y Specific ventilation often oriented to the exhaust requirement.y Separation of general occupancy spaces.y Orientation of heavy load laboratories away from additional burden of sun
gain.
y Corrosive effects of fumes on parts of the air conditioning, ventilation andexhaust system.
y Diversity in loads throughout the building.y High load variation in each laboratory.y Diversity in use of laboratories.y Explosion hazards.y Constant or variable exhaustsy Concentrations of sensible or latent heat, requiring either special exhaust or
spot cooling or both.
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Lighting System
There are so many variables in Health Research Centre lighting to choose
such as examination rooms, surgical suites, to doctors offices, we need to carry the
highest quality, state-of-the-art Health Research Centre lights.
Before selection and design for the Health Research Centre lighting systems, we
need to consider the factor in providing the best necessary service in Health
Research Centre lighting. The following selection factor should be taken into
account when selecting light for Health Research Centre:
y Lamp efficacyy Lamp pricey Lamp lifey Lamp availabilityy Color temperature between 3300 K and 5300 K
Life cycle costing
Life cycle costing for a 20-year period of lamp running and replacement was
carried out using a model developed for a major Health Research Centre. Generally,
24 hours per day operation for 7 days a week that should represent the expected
operating range for Health Research Centre lighting. Its depending on the hours of
usage.
Lifts System
Lifts or elevators are known as vertical transportation systems. A lift is
defined as an appliance designed to transport persons or materials between two or
more levels in a vertical direction by means of a guided car or a platform. The
development of lifts was felt necessary to encourage the construction of tall
buildings. Since lifts are possible sources of accidents in building, special care
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should be taken in designing, installing and maintaining the lifts in good working
condition. A thorough coordination should exist between the architect or engineer
and the lift manufacturer to arrive at the number and position of lifts for attaining
optimum efficiency in serving the building. The different types of lifts that are in
use are:
Passenger lifts are used to transport the public, staff, and ambulatory patients
(wheelchairs).
Health Research Centre service lifts are used to transport employees, patients, and
equipment or carts. Patients may be on foot, in wheelchairs, on gurneys or beds.
Combination passenger and service lifts are installed where combined use is
possible without interfering with normal activities, i.e., outpatient, domiciliary, and
nursing home care facilities.
Factor should be considered when providing the lifts
1. Lift PitsA lift pit is the space in the lift well below the level of the lowest lift landing served.
It should be provided at the bottom of every lift. The pit should be maintained in a
dry and clean condition. Where the pit depth exceeds 2 m, suitable access should be
provided by a cat ladder. The water pump can be installing to keep it dry for the
case that lift pit at the basement level.
2. Lift WellsThe unobstructed space within an enclosure provided for the vertical movement of
the lift car and counterweight including the lift pit and the space for top clearance is
known as the lift well. No equipment except that forming a part of the lift or
necessary for its operation and maintenance should be installed in the lift well.
Sufficient space should be provided between the guides for the car and the side
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walls to allow safe and easy access to the parts of the safety gears for their
maintenance and repairs.
3. Lift Machine Rooms:Lift machine rooms shall be large enough to install the lift equipment, including
space for controllers. Clearances for control equipment shall be not less than the
required and with enough working space between the various items of equipment
for maintenance purposes. It must be possible to remove major equipment
components of each lift for repair without dismantling components of an adjacent
lift. Minimum headroom shall be 2300 mm (7'6").
Lift machine rooms shall be of fire resistant construction equivalent to hoist way
construction and the machine room side of floors, ceilings, and walls shall have a
smooth surface equivalent to a well pointed smooth face tile or brick plaster or
smooth concrete. Exposed spray on fireproofing shall not be used in lift machine
room. Walls, ceilings and floor should be painted a light color. Floors shall be
sealed to eliminate concrete dust.
Industrial stairs shall be provided for convenient access to machine room. Geared
machines shall be mounted on vibration and sound isolating devices. These
isolating devices, when required, shall be of design to conform to seismic design
requirements. Skylights shall not be installed in lift machine rooms. Provide
adequate air conditioning, heating, and ventilation in machine rooms.
Adequate lighting shall be provided to insure proper illumination in the front and
rear of all controllers, supervisory and selector panels and over each hoisting
machine. Convenience outlets shall be provided for each lift area within the
machine room.
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4. Power Supply(i) Main Power:
Each lift shall be provided with a separate three phase supply through a circuit
breaker located in the respective machine room, adjacent to the entry and with clear
access. The supply should terminate at the respective lift controller. Indicate the
design electrical loads; (horsepower, voltage, amperage etc.) switch sizes, breaker
settings, wire sizes and conduit sizes.
The lift supply shall be dedicated main feeder utilizing the shortest practical run and
continuous ground conductor.
(ii) Auxiliary Power:
The lifts shall be arranged to have auxiliary power available with the capacity to
operate one lift at a time.
If emergency generator is not available, then hydraulic lifts shall be provided with
energizing to the down valve to bring the lift to the bottom floor and maintain an
energized door open button.
5. Communication:Each lift will have an intercom system in place of a telephone. Conduit must be
provided from the lift machine room to a 24 hour monitoring location. Its can be use
for the passenger when the lift breakdown.
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Fire Protection
Modern buildings require not only means of escape, access for the fire
brigade and structural protection, but also first aid equipment for occupants to use
on small fires while waiting for the arrival of the brigade and in some cases fixed
installations to help contain the fire until the arrival of the fire brigade. In very large
and high building special installations may also have to be provided for the fire
brigade. Expert advice on the appropriate provisions and the maintenance desirable
for particular cases may be obtained from local fire brigades, which normally
maintain an office for this purpose. .
A building cannot be made fireproof as there is no building material which is fully
fireproof. The building can only be made fire-resistant within reasonable limits by
using material that is fairly resistant to fire. The spread of fire can be considerably
delayed by adopting certain practices so that occupants have enough time to escape
to safer places in case a fire breaks out.
The object of a fire-resistant construction is to protect the lives of occupants, goods
and activities in a building. The degree of fire-resistance required depends on the
occupancy or use of the building. Town halls, theatres, schools, hospitals require a
greater degree of fire-resistance than a warehouse.
It may be very costly to make a building fire-resistant. The amount spent in making
a building fire-resistant should be related to the occupancy as also the possible loss
that may be caused in case of a fire outbreak.
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Other Consideration Factors
The other factors that need to consider in providing of 20 story Health
Research Centre complex is shown below:
1. Fire Fightingy For buildings over 24m in height, hydrants with wet risers and fire hoses (or
dry riser with outlets) should be installed in the premises and at all floors so
as to make water available within short reach for fire fighting. For buildings
over 60m in height, pumping and special pressure reduction arrangements
should be made. Water should always be made available to run the sprinkler
or emulsifier system connected through a pipe to an overhead tank of
suitable capacity. A separate fire sump or underground tank of sufficient
capacity with a pump that starts automatically in case of fire (due to pressure
drop as water is used for firefighting) should also be provided. In this case
the building is over 60m.
y Hydrant systems (fire hose) or rising mains should be installed in buildingsmore than 30 meters in height or where a single floor exceeds 1000 square
meters.
2. Fire preventiony The fire door and door frame are been use between two different unit and the
case between interior and external.
y The fire door should be provided with automatically close (to keep the firewithin the room itself) at every door which uses to exit to the emergency
staircase.
y A conduit wiring system should preferably be adopted. The wires are run insteel orP.V.C. conduits which provide protection from the risk of fire the
conduits should be laid below the false ceiling so that any short circuit or
spark can be easily attended to.
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y 3 Fire extinguishers are required for every 150m2 or 1 Fire extinguishersevery 100m for the corridor. Carbon Dioxide [CO2] is for electrical use and
ABC type is for others use.
3. Fire Detectiony Smoke sensor or gadgets are permanently installed in buildings for the early
detection of fire. And it must be make sure can function and not be close or
hiding by others object.
y Heat detection must not install close to the light or others electricalequipment. Because it may affect the detector function.
y Firemen switch must follow the standard requirement height 1.5m fromfinishing floor. Easy to see by people and use it if necessary.
y Health Research Centre containing records should be protected by firealarms (firemen switch alarms). The alarms must be sufficiently loud to be
heard in all parts of the building.
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Gas
The exacting nature of medical science focuses demand on improved
medical facilities with more reliable and effective medical support services. It is
primary objective of suppliers of medical gas distribution systems to provide the
creative technical service and quality products that keep pace with changing needs.
Since central piping systems supply medical gases in life support situations, it is
essential that the reliability and integrity of the system be the responsibility of all
professions- manufacturing, design, installation, testing and operation. There are
four medical gas systems normally installed and piped into medical care facilities.
Oxygen is used primarily for respiratory therapy and anaesthesia. Constant supply
and immediate availability throughout the Health Research Centre is essential. The
system is designed to provide 60 psig at the outlets. Nitrous oxide is used primarily
used in OT area. Pressure required at each outlet is 60 psig.
Medical air (compressed air) is primarily used for respiratory therapy in areas like
nurseries, emergency rooms, intensive care areas,
Although vacuum is not a medical gas, it is an essential part of medical gas system.
Vacuum is widely used throughout Health Research Centre facilities in patient
treatment and in laboratory. In surgical recovery and intensive care areas.
For ensuring this, the entire system need to be designed, installed and commissioned
with high degree of technical expertise skill and experience. The design and
planning of a medical gas distribution system may be divided under the following:
1. Location where it is required and the number of outlets.
2. System pipeline routing and determination of size of pipes.
3. Medical gas supply source.
4. Intermediate pipeline controls.
5. Gas service outlets.
6. Critical care area equipment.
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7. Alarm monitoring equipment.
8. System specification.
Water Supply
In the design of public and commercial buildings, engineering firms
commonly approach the problem as build it and plug it in to power, water, and
natural gas and flip the switch. As long as water, gas, and electricity are available
this works. In the event of a natural disaster this may not work.
It is important for property managers, building owners, hospitals, schools
and others to plan ahead for their emergency water needs in terms of the hardware
and the source of water.
Contingency Planning
1. SourcesBackup water supplies include ground-water from on-site wells or water that is
trucked to the site. In either case, on-site storage and water treatment are anecessity. Emergency water storage was in the form of a very large steel tank on
the roof of the Health Research Centre. Its elevated position provided gravity flow
through the Health Research Centre.
Ground water must be tested to ensure that it meets the Safe Drinking Water Act
standards and care must be exercised in the analysis.
2. StorageWe mentioned above storage tanks on the roofs of buildings that gravity feed into
the Health Research Centre. This is a particularly sensible option because during
emergencies electric power for pumps may not be available. Further pumps
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necessary to pump water to the top floors of a multistory building may not be
available.
Alternatively storage may be at ground level and may take the form of water bags or
water buffalo. Water buffalo come in nearly any size and are fitted with a wide
range of fittings and couplings. They are set at ground level or on elevated beams
to provide head. They may also be connected to pumps to move the water through
buildings and fixtures. The water buffalo can be connected to headers or manifolds
that have been equipped with spigots for distribution to small water containers or
hoses. The water buffalo alternative can be considered as either permanent or
temporary. The bags can be rolled up and stored when not needed.
Another option is a permanent on-site steel storage tank that is filled from water
trucks or municipal water as long as it is flowing.
3. Water TreatmentAll of the sources of water and alternative storage options can possibly provide
pathways of contamination. If water is not used it may stagnate in storage tanks.
Therefore, continuous treatment is needed in which water within the storage tanks
or water buffalos circulate continuously and water is treated to a stable residual
chlorine level. There are a number of systems that can perform this function.
Water Bank has evolved systems that it prefers and which are trouble free.
4. Design and Water SourcesWhen Water Bank was asked to provide emergency water for tall buildings. Each
building is unique in its height, water needs, and plumbing system. Consequently
each building needs to be uniquely engineered and this takes time. In some cases, a
one size fits all configuration can be worked out if water buffalos are used. These
are move-in move-out systems. They are modular systems to meet the needs of a
particular situation.
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Water sources must be identified ahead of time and arrangements developed for
equipping fire hydrants with water meters. All municipalities charge for installation
and removal of meters, weekly or monthly meter rental, deposits, and actual water
charges
Telephone/Fax System
Intercom systems are the communication solutions used daily by thousands
of Hospitals, Health Centers and Dental Surgeries.
Health Research Centre communications for departments inc. Accident &
Emergency, Radiology (X-Ray), Theatres, and Clean Rooms.
1. Operating TheatresHands free communications in an O perating Theatre or Sterile Department is
essential. The range of Clean Room Stations, include models that are designed
especially for clean room sterile environments, the stations faceplates have a
membrane that covers the keypad, loudspeaker and microphone, so allowing the
stations to be wiped down with disinfectants.
2. Health Care, Doctors Surgerys, Dentist SurgeryThe Intercom Systems are designed to meet the most demanding of requirements in
the Health Service whether it is NHS orPrivate Healthcare. The installation of an
Intercom/Public Address System will provide essential communication for staff and
patients and also a more pleasant environment with the use of background music.
The optional interfaces for CCTV and Access Control systems will allow for thefree movement of staff and controlled movement of visitors and patients.
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3. Accident & Emergency (A & E) & Walk In Departments Intercom points at Reception, Triage, Nurses Base, Consulting & Examination
Rooms, corridors and staff rooms provide an overall coverage for the department,
for either contacting individual members of staff or emergency calls. The waiting
rooms have loudspeakers installed enabling staff to call for the next patient and
provide background music. With additional intercom station points in other
departments such as X-Ray, Medical Records and Theatre, provide an additional
fast communication link to enable staff to make better use of their time and
resources
4. Radiology (X-Ray) DepartmentsGood communications between the different areas is essential to the efficient
running of the department to enable staff to make best use of the often, limited
resources.Loudspeaking intercom links between receptionist, waiting areas, X-Ray,
MRI and EBCT suites provide staff with a communications features that are not
available on a standard telephone system
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Conclusion
As what we know a Health Research Centre is an institution for health care
providing patient treatment by specialized staff and equipment, and often but not
always providing for longer-term patient stays.
Health Research Centres are usually funded by the state, by health organizations,
health insurances or charities, including by direct charitable donations. However,
Health Research Centres were often founded and funded by religious orders or
charitable individuals and leaders. Similarly, modern-day Health Research Centres
are largely staffed by professional physicians, surgeons, and nurses, whereas in
history, this work was usually done by the founding religious orders or by
volunteers.
Without all the major factor that had been discus above surely a Health Research
Centre complex will not withstand. I hope that with the information given can
minimize the interruption as well as providing comfort to he staff, patients and
visitors that come to the Health Research Centre.
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References
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1999.Innovative design solutions in key areas such as lighting, acoustics,
color, and finishes
4. Design Guide forImprovingHospital Safety in Earthquakes, Floods, andHigh Winds: ProvidingProtection to People and Buildings. FEMA, 2007.
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1992.
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York: John Wiley & Sons, Inc., 2002.
12.UFC 4-510-01 Design: Medical Military Facilities