ACHARYA’S NRV SCHOOL OF ARCHITECTURE

SOLADEVANAHALLI, BENGALURU -560107

PROJECT TITLE
ARCHITECTURE DESIGN PROJECT (THESIS) – 2021-22

Submitted in partial fulfillment of the Requirements for the

“Bachelor of Architecture” Degree Course

Submitted by : Ananya Kulkarni

USN : 1AA17AT009
Guide : Ar. Abhilasha

A project report submitted to

VISVESHWARAYA TECHNOLOGICAL UNIVERSITY
“Jnana Sangama”, Machhe, Belgaum – 590018

ವಿಶ್ವ ೇಶ್ವ ರಯ್ಯ ತಾಂತ್ರಿ ಕ ವಿಶ್ವ ವಿದ್ಯಯ ಲಯ್, ಬೆಳಗಾವಿ - ೫೯೦೦೧೮

 CERTIFICATE

This is to certify that this thesis report titled Trauma Centre by Ananya Kulkarni of

IX SEMESTER B. Arch, USN No. 1AA17AT009, has been submitted in partial

fulfillment of the requirements for the award of under graduate degree Bachelor of

Architecture (B.Arch.) by Visveshwaraya Technological University VTU,

Belgaum during the year 2021- 22.

Guide

Principal

Examined by :

1)Internal Examiner :

2)External examiner 1 :

3)External examiner 2 :

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 DECLARATION

This thesis title “Trauma centre”, submitted in partial fulfillment of the requirement

for the award of the under graduate of Bachelor of architecture is my original work to

the best of my knowledge.

The sources for the various information and the data used have been duly

acknowledged.

The work has not been submitted or provided to any other institution/ organization for

any diploma/degree or any other purpose.

I take full responsibility for the content in this report and in the event of any conflict

or dispute if any, hereby indemnify Acharya NRV School of Architecture and

Visveshwaraya Technological University, Belagavi and its official representatives

against any damages that any raise thereof.

Students Name : Ananya Kulkarni

USN No. : 1AA17AT009

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 ACKNOWLEDGEMENT

The satisfaction and euphoria that accompany the successful completion of my task

would be incomplete without mentioning the people, who made it possible, whose

consistent guidance and encouragement crowned our effort with success.

I have been fortunate to have Ar. Abhilasha, professor at Acharya NRV school of

architecture as my guide for the project. I would like to thank her for guidance and

constant support.

I am priviledged and honoured to thank Ar. Sanjyot Shah, principal of Acharya

NRV school of Architecture for constant support.

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 TABLE OF CONTENTS

CHAPTER NO. & TITLE PAGE

1. INTRODUCTION
- GENERAL 7
- TRAUMA CENTRE V/S EMERGENCY 9
- DISCIPLINE 13
- AIM, OBJECTIVES, LIMITATIONS 14
- ESSENTIAL SPACES 16

2. NET CASE STUDIES

2.1 NEW ZAYED MILITARY AND TRAUMA CENTRE 18
2.2 LEISHENSHAN HOSPITAL 27
2.3 UNIVERSITY PSYCHIATRIC CENTRE 33

3. BYE LAWS 37

4. SITE STUDY AND ANALYSIS 39

5. CONCEPT 42

6. REFERENCES/BIBLIOGRAPHY 43

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1. INTRODUCTION:

In Southeast Asia, accidents and injuries are increasingly becoming the primary causes of

morbidity and mortality. Developing countries are becoming more vulnerable to disasters due

to increased urbanisation and technological use without corresponding increases in

precautionary measures and workplace protection.

India alone lost – 26.7 million

It is estimated that 11 people will be injured/ killed every minute by 2001.

Health care systems are insufficiently prepared to manage incidents of trauma, accidents and

mass casualties, as the essential infrastructure is lacking.

To reduce morbidity and mortality, reinforcing of primary/secondary/tertiary health care is

necessary.

It is urgent need to establish health care facilities as the large number of trauma cases is of

young adults and those in productive age group.

Trauma centre has to have minimum human resources and equipments to ensure minimum

level of preparedness for the effected patients.

The lack of specialised equipments and operators is the major weakness seen in the existing

trauma care systems.

A trauma centre is a section of a hospital dedicated to treating the most critical injuries, such

as gunshot wounds, serious vehicle accidents, and major burns. Trauma centres provide more

comprehensive care than emergency rooms, and the distinction between the two can be the

matter of life and death.

Trauma centres are reserved for patients who have suffered the most severe injuries.

Trauma centres require highly qualified doctors that specialise in the treatment of catastrophic

injuries, such as:

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• Radiologists

• Trauma surgeons

• Registered nurses

• Cardiac surgeons

• Neurosurgeons

• Orthopaedic surgeons

They staff the center 24/7 and have access to resources such as an operating room,

resuscitation area, laboratory, and diagnostic testing equipment. They are always prepared to

treat patients.

There are 118 trauma centres in the whole of India. The deaths due to accidents reported is

increasing every year. Introducing trauma centres at the required areas is utmost important to

reduce the number of trauma deaths.

Patients with serious injuries require extensive care from a variety of experts, including

physiotherapists, occupational therapists, speech therapists, psychiatrists, vocational

therapists, and rehabilitation nurses, who will help the patient return to a state of normalcy.

POST TRAUMA STRESS DISORDER:

Without the support of qualified psychiatrists, psychologists, and Rehabilitation

professionals, some patients after a traumatic event have night terrors, flashbacks, insomnia,

irritability, and trouble moving on with their life.

Trauma surgeons, Orthopedic surgeons (both adult and pediatric), Neuro and Spine surgeons,

Plastic and General Surgeons make up the Trauma team. Anesthetists, cardiologists,

neurologists, physicians, and intensive care specialists support the surgical team.

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The Evolution of Trauma Care:

The evolution of trauma care began in Europe in the 17th century, with soft tissue techniques

being used to treat injuries. Following the American independence war, American doctors

educated in England and Scotland accepted these European values. Blood transfusions were

proven to save lives throughout the first and second world wars. The need of immobilizing

fractured limbs and then medically stabilizing them with implants became widely known.

Since the Korean War, it was discovered that after a trauma, blood vessel fluid moves into

cells, causing blood volume to be depleted. The importance of transferring patients swiftly to

hospitals by air ambulances was recognized at that time.

TRAUMA CENTER vs EMERGENCY DEPARTMENT:

The distinction between an emergency room and a trauma centre is both legal and degree-

based. – All hospitals are mandated by law to respond to all medical crises as soon as possible,

and hence must have emergency services. Emergency departments are designed to handle a

wide range of minor to major medical emergencies, but trauma centers have a narrower scope

of practice and rigorous staffing, specialist availability, and response time standards to care

for the seriously injured. An emergency room can be designated as a Trauma Care Facility

based on its ability to manage serious injuries. The emergency rooms of hospitals that are not

really classified trauma centers may not have coordinated multi-specialty teams ready to react

to trauma calls or access to the same degree of rapid, high-level surgical care as a recognized

trauma centre.

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Trimodal distribution of trauma deaths:

Trauma-related death is thought to be distributed in a trimodal fashion. This concept describes

three distinct peaks correlating with immediate, early and late death from trauma.

The first peak represents immediate death within the first hour following trauma and accounts

for 45% of patients.

The second peak represents death within 1- 4 h after trauma. This peak contains 34% of all

deaths. In this period, there is a critical interval between injury and treatment.

The third peak represents approximately 20% of deaths occurring more than 1 week after

trauma.

The ability to evaluate the arrangement of trauma care, resources, and more targeted research

to improve quality of care of trauma patients requires knowledge on the time of death

distribution.

Clinicians use the Advance Trauma Life Support (ATLS) protocol in trauma settings. The

concept can be broken down into three sections:

1) Primary survey and resuscitation

2) Secondary survey and examination, and

3) Definitive care and transfer

The guideline is described in full in the next section, which places it in the context of the

environment, tasks, and goals:

Trauma Domain Description - Trauma Team Structure:

The core team typically includes the attending surgeon, residents, an anesthesiologist, and

nurses.

A respiratory therapist, chemist, and X-ray technician are among the team's supporters.

Members of the team's roles and duties are clearly defined. The trauma team leader is in

charge of the incident, making significant decisions and directing duties to other team

members.

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A fellow physician might assist the trauma lead. The helping physician conducts a hands-on

examination and makes treatment recommendations. The main trauma nurse is in charge of

the patient's immediate care. The main trauma nurse may be assisted by a nurse recorder who

records occurrences in process sheets. The team's organization is frequently fluid.

Fellows and attending surgeons may alternate in the roles of team leader and assistant

physician. In selected hospitals, attending surgeons primarily serve as mentors to trainees who

serve as trauma leaders.

Walkthrough of a Trauma Scenario:

Regardless of the type of trauma, certain important stages (in quasi-sequential sequence) are

undertaken to evaluate the patient. At this section, we'll go over a common trauma case

scenario seen in a trauma centre (workflow depicted in Flowchart). This phase will focus on

workflow seen on site at a Level-1 Trauma Center and current literature on ATLS

recommendation adherence.

Trauma Preparation:

A trauma scenario usually starts with a severity or incident classification indicator announcing

the trauma arrival. In the Trauma unit, provider teams are assembled depend on the

seriousness of the trauma. The clinicians have a short window (varying from 2 to 10 minutes)

after the required staff members have assembled to do various activities in preparation for the

case at hand.

Members may, for example, share case information or scrub and dress in suitable protective

gear. When the patient is admitted, emergency hospital professionals move him to the trauma

bay and give him a quick rundown of his medical history. The trauma leader now assumes

command of the situation and begins the primary survey.

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Primary Survey and Resuscitation:

The leader assesses the patient's air passages, breathing, circulation, and neurological status

during the primary survey. Typically, this assessment is completed during the first two

minutes of the patient's arrival. Other members of the team execute resuscitative attempts

(orders from the leader) and patient exposure in simultaneously (primary nurse and assisting

physician).

After all life-threatening situations have been addressed, the team uses available testing to

evaluate patient trauma and administer necessary treatment.

Secondary Survey and Definitive Care:

The secondary survey, which includes a complete head-to-toe assessment of the patient, can

be done while awaiting the results of diagnostic tests. Following that, the trauma leader

develops a therapy plan. If necessary, physicians may confer with the supervisor (attending

surgeon) or a specialised speciality (for example, orthopaedic or plastic surgery consult).

Following that, the team can provide definitive care (treatment of conditions that were not

addressed at the end of the first survey) and conduct tertiary surveys. When the patient is ready

to go home from the trauma centre, they may be discharged or transported to a room for

observation and additional care via a consult.

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DISCIPLINE:

Social architecture:

Architecture has a tremendous impact on its occupants, not only on a societal level as well as

on a more intimate level. Buildings have an ever-changing and long-lasting impact on the

communities in which they are located. Spaces and buildings must adapt to meet the

requirements of coming generations as the world population expands. When a physical

environment is sensitively organized and configured, it can enhance productivity

Socially responsible architecture is the conscious design of an environment which encourages

social behaviour of the people leading towards the same goal or a set of goals. People-

gathering social condensers – areas where designed space and cultural progress collide.

It's a human-centered architectural approach that combines the concepts of "for the people –

by the people."

The state of public and social areas has had a significant impact on social interaction.

Designing a system that utilizes inherent social behaviour to recognize and reward a different

approach is more likely to result in change.

Contextually, social architecture can be considered in rural and urban.

Architects' social responsibility stems in part from their belief that design can improve

locations, have an impact on society, and even play a role in civilising a place by creating a

community more habitable. Social and environmental obligation are inextricably linked. The

built environment emits more pollutants than the transportation sector. As a result, architects

must incorporate energy-efficient systems that result in reduced energy usage, as well as

sustainable or renewable building materials, to minimise emissions and counteract the effects

of climate change and enhance the state of the globe. Getting more bang for your buck when

it comes to solving challenges.

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 Aim:

To reduce the percentage/ number of deaths and other damages (post trauma disorders) caused

due to high-risk injuries and to give more importance to the mental health.

Goal:

To increase in number of trauma hospitals and to provide the best facility to the high risk

injured patients (physical/mental). Due to growth in number of vehicular populations, the

number of fatalities has been steadily increasing.

The spotlight on mental health is slowly increasing and and to provide the proper space for

treatment and curing of post traumatic disorders.

Due to lack of facilities in India for the trauma accidents, trauma impact on mental health,

designing a building which can treat both mental and physical traumas can save many lives.

Report says:

Death due to mental trauma:

According to the World Health Organization, India's mental health burden is 2443 disability-

adjusted life years (DALYs) per 100 000 people, with a suicide rate of 211 per 100 000 people.

Death due to physical health:

As per the report of 2001 The National Crime Records Bureau (NCRB), 2,710,019 accidental

deaths, 108,506 suicidal deaths and 44,394 violence related deaths were reported in India.

Objectives/ target:

• To provide all the equipments, ambulance with emergency kit, with experts like, Trauma

surgeons, Neurosurgeons, Orthopedic surgeons, Cardiac surgeons, Radiologists, Registered

nurses.

• Providing immediate stabilization to the injured within the golden hour is crucial for this

method. The time between the injury and initial stabilization is the most critical period for

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 the patient's survival.

• To provide facilities, expert staffs and a design which helps to recover from the post

traumatic disorder.

Strategies:

• To provide the design which will make the movement of patients easier and saves time, as

the time is the most important factor for the trauma patients.

• To have a design for patients based on the severity of the injuries.

• Provide emergency hybrid rooms to stabilize the patients.

• Design and provide facilities which soothes the mind to support the mental trauma patients.

• Crowd free entrance to the hospital for the ambulance to transfer the patients to the required

rooms for the treatments.

Scope:

Achievable criteria for trauma care services that might be made accessible to practically

everyone who has been injured.

Limitations:

• The distance from the accident and the centre can be more leading to damages to the

patients. The medical staff - availability of the experts.

• Transfer of blood from blood banks might take time.

• The results revealed that the most common barriers are fear of stigmatization, lack of

awareness of mental health services, sociocultural scarcity, scarcity of financial support,

lack of geographical accessibility, that limit the patients to utilize mental health services.

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ESSENTIAL AREAS IN A TRAUMA CARE FACILITY:

Patient access:

• Ambulance entrance

• Walking entrance

Patient care areas:

• Triage & Reception area

• Resuscitation area

• Treatment area

• Ambulatory care area

• Waiting Area

• Observation Ward

• Isolation rooms

Clinical Support Services:

• Lab Services

• Radiology

• Blood Bank

• Pharmacy

• Communications

• CSSD

• Services

• Manifold

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Facilities for patient’s relatives:

• Waiting Area

• Communication Room

• Toilets

• Refreshment Area

Staff facilities:

• Staff changing rooms

• Staff shower and toilets

• Staff dining area

Office accommodation:

• Administrative support

• Staff offices

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2. NET CASE STUDY:

2.1: NEW ZAYED MILITARY AND TRAUMA CENTRE HOSPITAL:

Site Plan:

• Road ways are shown within the complex with driveways to the following:

• Loading Dock

• Main Hospital Entrance Secondary Entrance from Parking Structures

• Emergency and Trauma Centre Walk-in Entrance

• Emergency and Trauma Centre Ambulance Entrance Dedicated Psychiatric

• Medicine Entrance

• Physical Therapy and Rehab Medicine dedicated entrance

• Outpatient Clinic Building Entrance VIP dedicated entrance

• The Site Plan also shows Pedestrian Foot Passages

A connecting bridge from the Parking Structures to level 1and possible to level 2 of the

Diagnostic and Treatment

Centre, thus creating a secondary, secured and convenient entrance to the Hospital directly

from the Parking.

In addition to the available parking structures that will hold up-to 400 cars, there are

additional surface parking stalls adjacent the following critical services for the convenient

and easy access:

• Emergency Department.

• Physical Therapy and Rehab Medicine.

• Psychiatric Medicine

• Outpatient Building

• VIP

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While there is one Helipad located on the roof of the Diagnostic & Treatment Building, there

are two additional helipads located behind the Central Plant Building, with a short and direct

pathway to the Emergency Ambulance Entrance, to keep the dust and wind that will be

generated from the helicopters away from visitors and employees.

All the inpatient rooms overlook water features that are surrounded by greenery and special

landscaping.

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Building Organizations:

Private/Public Realms

The Hospital complex is comprised of separate and yet connected buildings (Three Pillars-

Inpatient, Diagnostic & Treatment, Outpatient) thus allowing ease of movement between the

buildings and consolidated support services to address the needs of the entire complex

Public areas are separated from Service areas.

Inpatient areas are separated from Outpatient areas

Separate Inpatient and Outpatient Access to Diagnostic & Treatment Services

The Diagnostic and Treatment in centrally located to support the inpatient and outpatient.

Inpatient flow is separated from Outpatient Flow.

in addition, direct and secured path for Critical Patient flow is provided.

Stacking Plan :

The proposed Stacking Plan promotes Quality and Efficiency through :

Minimized Patient Movement

Decreased Staffing and Equipment by eliminating unnecessary Space by consolidating similar

services

Reduced project Construction Cost and Time, accordingly.

The proposed plans can still achieve the above planning benefits even if the circular curve

massing becomes straight lines. Curve massing will minimize the institutional aspects of

linear building that usually consist of visible long corridors and doors that constitute

conventional institutional environment. (With the curved corridor, one will not see the end of

the long corridor and constantly appearing doors.)

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Nursing Unit Design :

The key attribute of our Stacking Plans is curved triangular nursing units where the visibilities

from the Nurse Station to the Patients rooms are greater to meet the increasing higher acuity

patient populations needs.

Patient rooms are not looking directly to each others windows.

VIP rooms can be located with greater privacy at either the extreme ends of each triangular

unit or the outer centre curves.

Two Nursing Units are connected for the Swing Bed capabilities for operational efficiencies

and for shared Support Space opportunities to optimize staffing and space efficiencies.

Therapeutic Garden Courtyard (or Atrium) is proposed between two Patient Units for view to

the outdoors and landscapes.

Of special note, two ICU/CCU and one Acute Care are proposed on the similar Floor Plate to

provide future conversion capabilities, to allow accommodation of higher acuity patients as

need arises in the future, with minimum remodel.

[ Multi-story high Atrium Lobby

Energy efficient Atrium is located between the Front Entrance and the Diagnostic and

Treatment Building which opens from the roof to the ground floor thus creating a modern

ambience.

Courtyard as Place of Respite

Courtyard is located on 3rd Floor to provide secured, respite space for patients, staff, and

family members.

Most of the general support departments are located in the basement level of the Diagnostic

and Treatment (D&T) Building and the Inpatient Building. ]

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B Level :

A connecting corridor connects the D&T building with the Outpatient Building thus achieving

optimal consolidation, integration and collaboration of the general support services.

A special hazard storage/vendor pick-up area is dedicated for storage and treatment of medical

waste.

The loading dock is large enough to support all services in the complex.

The Materials Management Department is sized large enough to handle the needs of the

institution but it shall still rely on replenishment from an external large warehouse,

incorporating just-in-time efficient operational protocol.

The inpatient pharmacy will dispense medication through the 'dumb waiter' to D&T

departments above for vertical transport and via pneumatic tube system throughout the

Medical Centre. An Automated Pharmacy and Supplies Dispensing System are proposed in

the medical equipment and IT budget.

CSSD is proposed to be located on the Basement with dedicated '2 smart elevators' (separate

clean and soiled) for vertical transport of case carts to Endoscopy and Surgery Departments.

Kitchen is proposed to be located on the Basement with dedicated 2 ‘dumb waiters' for vertical

transport of dietary carts to Patient Nursing Units

IT department is strategically located to support all buildings. The IT department will employ

the latest technologies in Hospital Information System (HIS), Clinical Information System

(CIS), Wireless communication, Financial System, and integration of medical equipment with

the HIS/CIS Systems

Medical Records is strategically located for future conversion of portion of the department

space to other patient support services when all EMR and space need is reduced

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Ground Floor :

The Emergency Department shall have dedicated 24 hour Radiology consist of a CT and X-

ray equipment’s for faster and more efficient point of care of emergency patients.

Emergency Department shall access vertically connected to Radiology Department floor

above for secluded and efficient patient

The Outpatient Psychiatry department is next to the Inpatient Psychiatry department and has

a dedicated entrance. In addition, a therapeutic garden shall be located in the inpatient

psychiatry department to allow for better healing and greater patient family interaction.

Additional outdoor area (or covered air-conditioned area) can be extended to inpatient

psychiatry area to allow for activities and exercise.

Rehabilitation is located on the ground floor in order to serve both the inpatients and the

outpatients. This affords easy and safe flow of patients in and out of the department.

Also, as a positive program attribute, a semi outdoor exercise area in proposed in addition to

surface parking access directly adjacent to the dedicated entrance on the back.

The Amenities including Health Education Resources and Food Retails are proposed on

Ground Floor for convenient access to outpatients and visitors.

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First Floor :

There is a connecting corridor that also connects the D&T building with the Outpatient

Building for convenient access The Amenities are located on this Floor to service large

population that uses this Diagnostic Services Floor.

The Radiology is consolidated on the first floor in order have more efficient operations. Its

location creates less congestion, pleasant healing environment and avoids having patients on

stretchers and heavy foot traffic that is traditionally present of the ground floor.

The Radiology Department is located above the emergency department (vertical adjacency)

for easy access by a dedicated elevator to some of the most sophisticated equipment.

Floors will be reinforced for heavy equipments transports; and exterior window /wall access

panel will be constructed to accommodate initial installation and future replacement of MRI

equipment and other heavy equipment.

The Endoscopy and Non-Invasive Cardiology, and Invasive Cardiology Departments are

horizontally adjacent to the Radiology Department to provide patient and physician

convenience which is a high efficiency factor. This is now a popular concept to consolidate

several diagnostic services that share a common support and nursing staff for specialized

procedures.

In addition, when necessary, this co-location of Radiology and Cardiology will allow

convergence of Imaging and Cardiology horizontally to promote interdisciplinary care for

patient-centered protocol and specialty collaboration for integrated care.

The Imaging / Radiology support services and offices are located on the same floor and next

to the Imaging Department in order to achieve better staff productivity There are four ICU/

CCU units on the first floor each with private rooms and all are intended to achieve swing

capability, flexibility and consolidation of support areas between units. Triangular nursing

units are proposed for the most visibilities from Nurse Station to the Patients rooms.

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Second Floor :

The Operating Theatres are located on the second floor with easy access (vertical) to the ICU

/ CCU units below.

Anaesthesia & Pain Management is next to the theatres to achieve greater staff efficiency.

The Laboratory is located next to the operating theatres as stat lab since most of the lab work

will be outsourced.

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Third Floor and Above

Executive Administration, Nursing Administration, Financing, and Quality

Control/Utilization Review/Risk Management Services are proposed to be located on this top

floor of the D&T Block that provides both required privacy as well as public access to provide

high patient relations services. The proposed location has direct adjacency to Education.

All of the Acute Care areas will be located from the third floor and above.

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2.3 : LEISHENSHAN HOSPITAL :

INTRODUCTION :

In January of 2020, Wuhan City Disease Prevention Headquarters agreed to construct

Leishenshan hospital within half a month. The former 2019 Military World Games (MWGs)

athlete restaurant has been converted into Wuhan's second hospital devoted to treating patients

diagnosed with the coronavirus disease 2019. One thousand six hundred beds were freshly

constructed.

• Leishenshan hospital was designed by Zhongnan Architectural Design Institute

• Organized by Wuhan Real Estate Group

• Constructed by China Construction Third Engineering Bureau as a general contractor.

In normal conditions, a hospital of this scale can only be constructed in 3 to 5 years, and

Leishenshan hospital had to be placed into service in 2 weeks.

At the building's peak construction time, more than 1500 pieces of machinery and equipment

were built for more than 10,000 employees.

The year's construction tasks were compressed into more than ten days. Therefore, modular

composite buildings' use, industrialized, and prefabricated construction methods are

inevitable for project construction.

The design and construction methods of prefabricated modular box buildings are different. It

uses a room as the basic unit and is relatively independent in structure.

The dimensional error between other systems will not affect the completion and overall use

of building construction.

the use of prefabricated modular box buildings can meet the demand to the greatest extent

and fully reflect the advantages of prefabricated buildings of “light, good, fast, energy-saving,

energy-saving and environmental protection.”

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Architectural planning and design :

Wuhan Leishenshan hospital is located north of Qiangjun Road, 2019 MWGs village, Jiangxia

District,

SITE SELECTION CRITERIA :

There is already a 300mm thick concrete hardened ground, which can be used as a basic cast-

in layer for the isolation medical area, significantly reducing the workload of site leveling and

speeding up Leishenshan hospital's construction

The site is flat and has a hardened floor, which is very suitable for constructing temporary

buildings.

Simultaneously, the roads around the site are open, the traffic is perfect, and it is far away

from the central urban area. The surrounding area is not yet developed and mature, with closed

control and isolation conditions. The distance between the overall building and the

surrounding roads and other buildings shall meet the infectious disease hospital's requirements

Air conditioning exhaust and sewage are discharged after disinfection, and rainwater is

released to the sewage pipe network after collection and disinfection.

According to landfill standards, a layer of High-density polyethylene (HDPE) anti-seepage

membrane was laid in the hospital area. The membrane is a kind of flexible waterproof

material with a high anti-seepage coefficient, excellent heat resistance, and cold resistance.

The hospital area is equipped with a sewage treatment station, the disinfection tank, the

integrated regulating tank, the biochemical tank, the efficient sedimentation tank, and other

environmental protection facilities.

The construction of Leishenshan hospital mainly uses containers for modular assembly to

form various functional modules of the hospital and uses BIM technology to assist in

automated construction.

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Structure design :

Superstructure design :

The container adopts a steel structure skeleton and color steel composite board wall as a

whole. The mainframe beams and columns are made of cold-formed steel welding.

The structure has strong integrity, high bearing capacity, wind resistance, earthquake

resistance, safety, and durability through the welding connection.

The box roof is equipped with a waterproof and thermal insulation system, and drainage

systems are hidden in the four corners.

The box is the basic unit and can be used alone or combined horizontally and vertically to

form a spacious use space and stacked vertically.

According to the production conditions of the manufacturer at the time, Leishenshan Hospital

adopted two box-type room units with dimensions of 3 m × 6 m × 2.9 m and

2 m × 6 m × 2.9 m.

The height of the medical technology area in the isolated medical area is 4.3 m.

All modules are prefabricated in the factory, transported to the roads around the site,

assembled outside the area, and hoisted.

Small pipelines inside the ward modules are reserved and embedded simultaneously. Some

unique function rooms, such as pharmacies, use boxes as the basic unit, forming a spacious

use space through different horizontal and vertical directions.

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Three zones and two channels :

The three zones refer to clean, semi-contaminated and contaminated areas, and the two

channels refer to the patient channel and the medical care channel.

The isolated medical area is a new temporary building, including 30 isolation wards and two

intensive care units. There is a sanitary passing unit, ward nursing unit, medical technology

unit, and reception area, excluding outpatient and emergency departments.

The plan is a “fishbone” layout, and each “fishbone” is an independent medical unit. The ward

is divided into north and south areas, each with 15 wards, and the ward spacing is 12 m.

Multiple H-shaped modules arrange the wards. Among them, the office area and medical staff

passage are placed along the central axis. Each central module is responsible for four.

Medical staff enters the ward through the “sanitary passage unit” from the central axis's core

through disinfection, dressing, and inspection

The medical and nursing living area has two floors

The main structure of the light steel movable board house is a lightweight steel frame, and

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there are cross cables between the frames to ensure the rigidity and stability of the structure;

the floor supporting system adopts a light steel truss with a wooden floor on it; the roof and

wall enclosure adopt sandwich color steel plate.

Hushenshan and Leishenshan hospital's key bodies are designed with light steel frameworks,

if Hushenshan hospital uses a container house as a building module unit, while Leishenshan

hospital as a building module unit is a steel frame.

Fig 6 – shows the assembled Leishenshan hospital's steel frame module.

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CONCLUSIONS :

It benefits from the efficient coordination ability of design and construction organization and

the more sophisticated light steel structure assembly modular building industry system.

Use BIM technology to realize site layout planning and design efficient-efficient design

solutions. So as to provide technical support for rapid construction.

Modular construction can increase construction speed by more than 50% while reducing costs.

It can increase productivity because different construction tasks can be completed at the same

time.

In the experience accumulation and post epidemic reflection of the Leishenshan hospital, it

provides experience for emergency construction under the background of frequent natural

disasters and infectious diseases.

Using BIM technology to assist in the whole process of design and construction, pre-

simulating the design plan and construction plan, and using structural assembly modular

construction technology, the large-scale construction was successfully completed in a

relatively short period of time.

In hospitals' construction, digital models enable companies to monitor the entire construction

process, using large amounts of high-tech technology such as big data, artificial intelligence,

drones, and 5G. It provides customers with a comprehensive construction model. The isolation

area is located in the first parking lot or green belt area. There is a hardened floor in the original

parking lot area, and the isolation area foundation

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2.3 : UNIVERSITY PSYCHIATRIC CENTRE :

LOCATION : Belgium

ARCHITECTS : Stephane Beel architects

The psychiatry building is part of AWG Architects’ master-plan for the further development

of the UZ Gasthuisberg campus. It is structured around an internal patio. The exentrically

position of the patio allows the creation of different sections for large therapy rooms and for

smaller spaces such as patients’ rooms.

The master-plan sets out measures to create an urban context, which include creating density

and differentiation in the public space, and building a diverse range of streets and squares.

This will enable the open ‘green’ zones around the site to be safeguarded.

The entire site is surrounded by a new ring-road, and a number of ‘main streets’ run through

the site to create structure. The psychiatry building, designed by Stéphane Beel Architects, is

located on the edge of this master-plan zone, in between the ring-road, the green zone and one

of the main streets. The master-plan allows for a building volume of five storeys.

The patio has been developed as a ‘therapeutic landscape’. This ‘landscape’ is connected to

every floor, so that patients can reach their therapy areas by passing through it. At the same

time, it is a place for relaxation and informal contact between patients, visitors and healthcare

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professionals. On the third floor, this ‘therapeutic landscape’ culminates in a spacious terrace,

which connects to the sports hall. From here, patients have a view out over the green zone

and Leuven city centre.

The central patio is covered with a sliding greenhouse roof, which creates a tempered outdoor

climate. This increases its potential uses, as well as having a positive effect on energy

consumption.

On the ground floor, adjacent to the main street, are the public functions: the reception area,

consultation rooms, training and administration rooms. On the first, second and third floors

are the hospitalisation units, together with their respective therapy areas. For structural

reasons, the double-height sports hall is located on the top floor.

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Much thought has gone into choosing the right materials and decoration. Perforated glazed

bricks and acoustically absorbent floors and ceilings have been used to create an acoustically

pleasant environment. More specifically, the rubber tiles chosen for the patio floor meet both

acoustic and other requirements (safety, look and feel, etc.).

Look and feel studies were carried out for the entire interior decoration. A lively colour palette

was created to complement the champagne-coloured masonry and it is by no means sterile.

Although this is a hospital, the idea is to create an environment that feels both homely and

safe. Based on detailed research, a standard room was designed with a colourful sliding

partition to conjure up a homely atmosphere.

The advisory role played by Stéphane Beel Architects in the choice of the free-standing

furniture ensured that the look and feel was implemented to maximum effect, and has resulted

in a harmonious whole.

Three oval green islands have been placed in the patio, which serve to bring it down to a more

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human scale.

The inner patio is surrounded by perforated brick-work. This material is absorbing and helps

to avoid loud noises in the patio. In the whole building there was a lot of attention to acoustics.

A crucial item to create a relaxing and tempering atmosphere.

This psychiatric patient center for adults and elderly people consists of 90 hospitalisation beds

(day and night), an ambulant center with day hospital for 25 additional patients, with the

related consultation, therapy and conversation spaces, and with the administration. Part of the

patient rooms are equipped with medical gas fittings. The building has 5 layers, enclosing a

central winter garden, as an additional protected living space for the patients. An integrated

design approach enabled for VK's sustainable and technical solutions to be integrated

seamlessly.

A motorised glazed roof covering the winter garden during the winter months creates a

thermal buffer between the indoors and the outdoors. During summer, temperature rises in the

winter garden can be regulated, with a maximum rise of 3°C on top of the outdoor temperature,

by completely opening the roof and through automated solar protection.

A well thought-out thermal insulation of the building envelope results in a building with

excellent airtightness, while dynamic outdoor solar protection strongly reduces the cooling

charges inside the building. The central air groups are equipped with a heat exchanger.

Heating and cooling are delivered by the central energy plant of the Gasthuisberg-site.

Energy consumption for electricity is further reduced by energy efficient lighting.

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BYE LAWS :

The Nursing Home shall be situated in a place having clean surroundings and shall not be

adjacent to an open sewer, drain or public lavatory or to a factory omitting smoke or obnoxious

odour.

The rooms in the nursing home shall be well ventilated and lighted and shall be kept in clean

and hygienic conditions. Arrangement shall be made for cooling them in summer and heating

them in winter.

The wall of the labour room and operation theatre upto a height of four feet from the floor

shall be of such construction as to render it waterproof. The flooring shall be such as not to

permit retention or accumulation of dust. There shall be no chinks or crevices in the walls or

floors.

An operation theatre shall be provided with, minimum floor space of 180 sq.ft

The floor space in the nursing home shall be 120 sq. ft. for single bed and additional 80 sq. ft.

for every additional bed in single room. Adequate arrangements shall be made for isolating

septic and infectious cases.

A duty room shall be provided for the " Nursing staff " on duty.

Adequate space for storage of medicines, food articles, equipments etc shall be provided

• Corridor width – min. 2m

• Ramp width – min. 2.4m

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Page | 38
3. SITE ANALYSIS AND STUDY :

LOCATION : WHITE FIELD, BANGALORE

ACRES : 7.25

LAND USE MAP :

- SITE

REASONS FOR SELECTING THE SITE :

Strength :

• It is in the area where IT sector is mainly seen.

• Its near main road (within 500 mtrs).

• Easy accessible.

• Surrounded by residences which will create a calm environment to the patients.

• Selected site falls under the area left for development according to the landuse map.

Weakness :

• Residence surrounding the site might disturb them due to ambulance movements.

Opportunities :

• Catalyst for developing the area and surroundings further more

• Provide better facilities and treatment to the patients.

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CLIMATE :

• The hot season lasts for 2.5 months, from March 4 to May 21, with an average daily

high temperature above 90°F. The hottest month of the year in Bengaluru is April,

with an average high of 92°F and low of 72°F.

• The cool season lasts for 3.3 months, from September 29 to January 6, with an

average daily high temperature below 82°F. The coldest month of the year in

Bengaluru is December, with an average low of 62°F and high of 80°F.

• The rainy period of the year lasts for 8.9 months, from March 20 to December 18, with

a sliding 31-day rainfall of at least 0.5 inches. The month with the most rain in

Bengaluru is September, with an average rainfall of 5.2 inches.

• The rainless period of the year lasts for 3.1 months, from December 18 to March 20.

The month with the least rain in Bengaluru is January, with an average rainfall of 0.1

inches.

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• The windier part of the year lasts for 3.0 months, from June 1 to September 2, with

average wind speeds of more than 10.5 miles per hour. The windiest month of the year

in Bengaluru is July, with an average hourly wind speed of 14.0 miles per hour.

• The calmer time of year lasts for 9.0 months, from September 2 to June 1.

The calmest month of the year in Bengaluru is October, with an average hourly wind

speed of 6.8 miles per hour.

• The length of the day in Bengaluru does not vary substantially over the course of the

year, staying within 53 minutes of 12 hours throughout. In 2022, the shortest day

is December 22, with 11 hours, 22 minutes of daylight; the longest day is June 21,

with 12 hours, 53 minutes of daylight.

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CONCEPT :

LIGHT AND SHADOWS / SHADOW ARCHITECTURE/ TREASURY OF SHADOWS :

According to Louis Kahn, light and shadows are giver of all presence.

• He states : “A plan of building should be read like a harmony of spaces intended to be

dark should have just enough light from some mysterious opening to tell us how dark

it really is. Each space must be defined by its structure and character of its natural

light”.

• Even a room which must be dark needs atleast a crack of light to know how dark it is.

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BIBLIOGRAPHY :

Louis Khan :
https://antonialoweinteriors.com/louis-kahn-an-architect-of-light-the-power-of-light-and-
shadow

Byelaws : (condensed)
https://mohua.gov.in/upload/uploadfiles/files/Chap-4.pdf

Net case studies :

2.1 https://www.architectmagazine.com/project-gallery/zayed-military-
ospital#:~:text=Project%20Description&text=LEO%20A%20DALY%2C%20design%20a
rchitect,located%20in%20downtown%20Abu%20Dhabi.

2.2 https://www.sciencedirect.com/science/article/pii/S0926580521000066

2.3 https://www.archdaily.com/804323/university-psychiatric-centre-stephane-beel-
architect#:~:text=The%20psychiatry%20building%2C%20designed%20by,building%20vo
lume%20of%20five%20storeys.&text=The%20patio%20has%20been%20developed%20a
s%20a%20'therapeutic%20landscape'.

Introduction :
https://morth.nic.in/sites/default/files/RA_Uploading.pdf

https://www.nhp.gov.in/world-trauma-day-2019_pg

https://share.upmc.com/2016/05/er-vs-trauma-center-levels/

https://dghs.gov.in/WriteReadData/userfiles/file/Operational_Guidelines_Trauma.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897990/

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