Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 (ICS 11.020; 91.040.10) TECHNICAL REFERENCE Facility design guidelines for acute general hospitals Published by Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 (ICS 11.020; 91.040.10) TECHNICAL REFERENCE Facility design guidelines for acute general hospitals All rights reserved. Unless otherwise specified, no part of this Singapore Standard may be reproduced or utilised in any form or by any means, electronic or mechanical, including photocopying and microfilming, without permission in writing from SPRING Singapore at the address below: SPRING Singapore 1 Fusionopolis Walk, #01-02 South Tower, Solaris Singapore 138628 Email: [email protected] ISBN 978-981-4726-01-6 Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 First published, 2015 NOTE 1. Users of this Technical Reference should refer to the relevant professional or experts for any technical advice on the subject matter. SPRING Singapore shall not be liable for any damages whether directly or indirectly suffered by anyone as a result of reliance on this Technical Reference. 2. Compliance with this Technical Reference does not exempt users from legal obligations. 2 COPYRIGHT Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 Contents Page Foreword 8 1 Scope 10 2 Normative references 10 3 Terms and definitions 12 4 Requirements common to all functional planning units (FPU) 13 4.1 Function and design considerations 13 4.2 Environmental considerations 16 4.3 Infection control 17 4.4 Building services 18 4.5 Power supply 21 5 Inpatient accommodation: General inpatient unit 23 5.1 General 23 5.2 Planning considerations 23 5.3 Function and design considerations 25 5.4 Environmental considerations 28 5.5 Infection control 29 5.6 Building services 30 6 Inpatient accommodation: Intensive care unit (ICU) 32 6.1 General 32 6.2 Planning considerations 32 6.3 Function and design considerations 33 6.4 Environmental considerations 36 6.5 Infection control 37 6.6 Building services 38 7 Inpatient accommodation: High dependency unit (HDU) 39 7.1 General 39 7.2 Planning considerations 39 7.3 Function and design considerations 40 7.4 Environmental considerations 43 7.5 Infection control 44 7.6 Building services 45 8 Inpatient accommodation: Isolation unit 46 8.1 General 46 8.2 Planning considerations 46 8.3 Function and design considerations 48 8.4 Environmental considerations 51 3 COPYRIGHT Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 8.5 Infection control 51 8.6 Building services 52 9 Outpatient accommodation: Emergency unit 54 9.1 General 54 9.2 Planning considerations 54 9.3 Function and design considerations 56 9.4 Environmental considerations 61 9.5 Infection control 61 9.6 Building services 63 10 Outpatient accommodation: Outpatient Unit – Specialist outpatient clinic (SOC) 64 10.1 General 64 10.2 Planning considerations 64 10.3 Function and design considerations 65 10.4 Environmental considerations 67 10.5 Infection control 68 10.6 Building services 69 11 Diagnostic and treatment areas: Operating unit 69 11.1 General 69 11.2 Planning considerations 69 11.3 Function and design considerations 70 11.4 Environmental considerations 75 11.5 Infection control 76 11.6 Building services 77 12 Diagnostic and treatment areas: Day surgery / procedure unit 78 12.1 General 78 12.2 Planning considerations 79 12.3 Function and design considerations 79 12.4 Environmental considerations 82 12.5 Infection control 83 12.6 Building services 84 13 Diagnostic and treatment areas: Endoscopy unit 84 13.1 General 84 13.2 Planning considerations 85 13.3 Function and design considerations 85 13.4 Environmental considerations 90 13.5 Infection control 90 13.6 Building services 91 4 COPYRIGHT Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 14 Diagnostic and treatment areas: General medical imaging unit 92 14.1 General 92 14.2 Planning considerations 92 14.3 Function and design considerations 93 14.4 Environmental considerations 97 14.5 Infection control 98 14.6 Building services 99 15 Diagnostic and treatment areas: Oncology – Radiotherapy unit 100 15.1 General 100 15.2 Planning considerations 100 15.3 Function and design considerations 101 15.4 Environmental considerations 105 15.5 Infection control 105 15.6 Building services 106 16 Clinical support areas – Pathology unit 106 16.1 General 106 16.2 Planning considerations 107 16.3 Function and design considerations 108 16.4 Environmental considerations 111 16.5 Infection control 111 16.6 Building services 112 17 Clinical support areas – Pharmacy unit 113 17.1 General 113 17.2 Planning considerations 114 17.3 Function and design considerations 114 17.4 Environmental considerations 116 17.5 Infection control 117 17.6 Building services 117 18 Clinical support areas – Renal dialysis unit 118 18.1 General 118 18.2 Planning considerations 118 18.3 Function and design considerations 119 18.4 Environmental considerations 122 18.5 Infection control 122 18.6 Building services 123 19 Operational support services – Sterile supply unit (SSU) 124 19.1 General 124 19.2 Planning considerations 124 5 COPYRIGHT Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 19.3 Function and design considerations 125 19.4 Environmental considerations 127 19.5 Infection control 127 19.6 Building services 128 Annexes A Corridor width guide 130 B Acoustic guide 131 C Room area guide 132 Tables 4.1 Load type categorisation 21 4.2 Definition of redundancy levels 21 5.1 Operational models for general inpatient unit 23 5.2 Operation models for nursing staff 23 5.3 Planning models for general inpatient unit 24 5.4 Functional areas for general inpatient unit 25 5.5 Provision of classed beds 26 5.6 Features of greenery provision and healing environment for inpatient unit 29 5.7 Modes of ventilation for wards 31 6.1 Operational models for ICU 32 6.2 Models of care for ICU 33 6.3 Functional areas for ICU 34 7.1 Operational models for HDU 39 7.2 Models of care for HDU 40 7.3 Functional areas for HDU 41 8.1 Operational models for isolation unit 46 8.2 Models of care for isolation unit 47 8.3 Classification and features of isolation rooms 47 8.4 Functional areas for isolation unit 48 8.5 Pressurisation requirements for isolation room(s) 53 9.1 Patient acuity category (PAC) scale 55 9.2 Models of care for emergency unit 55 9.3 Functional areas for emergency unit 57 9.4 Furniture and equipment (F&E) for emergency unit 60 10.1 Operational models for outpatient unit – SOC 64 10.2 Arrangement of consult / examination room(s) 65 10.3 Functional areas for outpatient unit – SOC 66 6 COPYRIGHT Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 11.1 Classification of operating room(s) 70 11.2 Planning models for operating unit 70 11.3 Functional areas for operating unit 71 11.4 Recovery areas in operating unit 72 12.1 Functional areas for day surgery/ procedure unit 80 13.1 Functional areas for endoscopy unit 86 14.1 Functional areas for general medical imaging unit 93 14.2 Radiation protection zones for medical imaging unit 96 15.1 Patient treatment phases for oncology-radiotherapy unit 101 15.2 Functional areas for oncology-radiotherapy unit 102 16.1 Sub-specialists disciplines and services of pathology unit 107 16.2 Models of care for pathology unit 107 16.3 Functional areas for pathology unit 108 17.1 Services of pharmacy unit 113 17.2 Models of care for pharmacy unit 114 17.3 Functional areas for pharmacy unit 115 18.1 Functional areas for renal dialysis unit 120 19.1 Functional areas for sterile supply unit 126 19.2 Air pressure requirements between areas for zones within SSU 128 A.1 Recommended corridor width 130 B.1 Recommended internal design sound levels 131 C.1 Recommended room area guide 132 Bibliography 133 7 COPYRIGHT Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 Foreword This Technical Reference was prepared by a Working Group (WG) appointed by the Technical Committee on Architectural Works which is under the direction of the Building and Construction Standards Committee (BCSC). The BCSC endorsed the Technical Reference on behalf of the Singapore Standards Council on 30 July 2015 Under the Healthcare 2020 Master Plan, one of the key highlights was to improve the capacity of healthcare infrastructure, to meet new demands in healthcare needs. Hence, there was a need to develop a set of design guidelines on facilities relating to acute general hospitals. These guidelines will benefit healthcare operators and planners to enhance quality and safety in the healthcare services. This Technical Reference will also form a basis for future design guidelines in other care models such as sub-acute care – community hospital, nursing home, specialist outpatient clinic and polyclinic. This Technical Reference is not to be regarded as a Singapore Standard. This Technical Reference is made available for provisional application over a period of two years, but does not have the status of a Singapore Standard. The aim is to use the experience gained to modify the Technical Reference so that it can be adopted as a Singapore Standard. Users of the Technical Reference are invited to comment on its technical content, ease of use and any ambiguities or anomalies. These comments can be submitted using the feedback form provided at the end of the Technical Reference and will be taken into account in the review of the publication. At the end of the two years, the Technical Reference will be reviewed by the WG to discuss the comments received and to determine its suitability as a Singapore Standard. Submission for approval by the Standards Council as a Singapore Standard will be carried out only upon agreement after review. For ease of reference, the tables in this Technical Reference are numbered to correspond with the respective clauses. In preparing this Technical Reference, the Working Group has incorporated inputs from the Association of Consulting Engineers Singapore, Association of Property and Facility Managers, Building and Construction Authority, Institution of Engineers Singapore, Ministry of Health, MOH Holdings Pte Ltd, Ministry of Manpower, National Environment Agency, Singapore Civil Defence Force, Singapore Institute of Architects, architects, consultants, medical planners as well as users and operators from the healthcare industry. This Technical Reference does not give exemption from the adherence to the relevant Authorities’ Acts and Regulations currently enforced, such as the following and the list may not be exhaustive. 1) Building Control Regulation 27, Approved Document - Acceptable Solutions, Oct 2013 2) Energy Conservation Act 2012 (No. 11 of 2012) and its Regulations 3) Environmental Protection and Management Act (Cap. 94A) and its Regulations 4) Environmental Public Health Act (Cap. 95) and its Regulations 5) Environmental Public Health (Cooling Towers and Water Fountains) Regulations 6) Code of Practice on Environmental Health 7) Code of Practice on Surface Water Drainage 8) Code of Practice on Sewerage and Sanitary Works and its amendments 9) Code of Practice for Fire Safety Precautions in Buildings (Fire Code) 10) Infectious Diseases Act (Cap 137) (Part V) and its Regulations 11) Medicines Act (Cap. 176) and its Regulations 12) Radiation Protection Act (Cap. 262) and its Regulations 13) Sewerage and Drainage Act (Cap. 294) and its Regulations 14) Workplace Safety and Health Act and its Workplace Safety and Health (General Provisions) Regulations 15) WSH Guidelines on Healthcare, Workplace Safety and Health Council (WSHC) 8 COPYRIGHT Licensed by SPRING Singapore to Ms Sharon Tay Lee Kat, Sengkang Health Singapore Standards Invoice No : LP2-IN0000028205 / Downloaded : 15-09-2015 Single user licence only, copying and networking prohibited TR 42 : 2015 This Technical Reference should be applied with good judgment and personal liability. Acknowledgement is made to the Facilities Guidelines Institute for the reproduction of their materials from the Guidelines for Design and Construction of Hospitals and Outpatient Facilities, 2014 edition, in Annex B of this Technical Reference. Attention is drawn to the possibility that some of the elements of this Technical Reference may be the subject of patent rights. SPRING Singapore shall not be held responsible for identifying any or all of such patent rights. 9 COPYRIGHT