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EASTWOOD CHILDREN'S HOSPITAL EL PASO, TEXAS

PRESENTED To - PROFESSOR W, LAWER"ENCE GARVIN DIVISION OF ARCHITECTURE TEXAS TEXAS UNIVERSITY

PRESENTED BY • JORGE VIRGEN - RJCH IN PARTIAL FULFILLMENT OF THE REQUiREMENTS OF THE BACHELOR OF ARCHITECTURE .DEGREE MAY 5 , 1982

TABLE OF CONTENTS

INTRODUCTION - HOSPITAL'S HISTORY.,... ,1

PROJECT STATEMENT - 7

BACKGROUND STUDiES o... ».. l-íf GOALS 18 OBJECTIVES . o • . . o • . o • • . . . « o . o o . 19

ACTIVITY ANALYSIS.o , ifO

SITE ANALYSIS ..o ^8

SPACE SUMMARY o. -23

SYSTEMS PERFORMANCE CRITERIA...o...o 139

COST ANALYSIS '• o...... ,o 172

DETAIL E D S PAC E LIST.o.•..••.»»•«»•»•••»•*••»»•«....o..•.»..« 1/7

CASE STUDIES., 3^5

CONCLUSiON.- •••« o 0.0 o 00 35'+

BIBLIOGRAPHY 3^3 HISTORY

Institutions for the care and shelter of the sick existed in ancient times. Many of them simply provided horaes for horaeless, helpless, or - infirm persons. These were hardly hospitals in the modern definition of that tem. Others provided such medical care and treatment as had been developed in their time and localities. There are records of hospitals in Buddhist India as early as the 3rd century, B.C. In connection with the temples of Aesculapius in ancient Greece and some of the Aegrean -

Islands there grew up raedicalschools , and in connection with them, - hospitals in which priests of the cult of this. Greek godof medicine ministered to the sick. There are records of hospitals in Rome in the early centuries of the Christian era.

The revival of piety in the llth century, pilgrimages to holy places and the Crusades led to the establishraent of many hospitals and to the development of religious orders whose members ministered to the sick.

Famous araong these orders is that of the Krdghts Hospitallers of St. John of Jerusalem, sometimes known as the Knights of Malta. The order has been continuously serving the sick in many lands. At Valetta the order built and maintained a large hospital in which members ministered personally to sick patients. After their expulsion from Malta by Mapoleon, the -

Knights established their headquarters in Rome and since that time have cared for sick and wounded soldiers of many European wars, maintaining hospitals, ambulance service, hospital trains, and the like. Other religious orders founded during the Middle Ages operated hospitals 1/ and nursed the sick and still continue to do so.

In England during the Middle Ages hospitals were founded to serve a variety of social needs. Many of them were for lepers; others housed aged, infirm, and horaeless persons, or provided lodging for pilgrims and wayfarers. Their care of the sick was only incidental to their - other functions. Practically all of them were maintained by monastic orders or other religious foundations. The slow disappearance of - leprosy and the econoraic decline toward the end of the 15th century and the beginning of the l6th led to the closing of many of these institutions.

The final blow came when Henry VIII dissolved the religious houses and confiscated their properties. Through the efforts of London citizens,

St. Bartholomew's and St. Thomas's were reopened, and in the reign of

Edward VI these institutions became, in a sense, municipal hospitals.

The beginnings of hospitals in the English colonies in America, which later becanie the United States, followed neither the plan of the organization of charities by the church nor that of cities to provide institutional care for the indigent sick. This is explainable from the facts that the

Catholic Church, the chief dispenser of organized religious charity in Europe, did not flourish in the colonies, and that the early American settlers became farmers in stead of establishing themselves in towns, there being prior to the Revolutionary War very few towns in the - colonies larger than villages. The scattered population had relatively few physicians outside of New York, Philadelphia, Boston, and Charleston

In Virginia, the Church of England through its vestries managed local civil affairs, including poor relief, but it did not establish hospitals the population being alraost entirely rural. In Maryland, the Catholics were not iong enough in control of public affairs to develop the system of charities which the Church fostered in Europe.

The earliest attempts to establish hospitals were sporadic and - designed to meet local needs of specific nature. The first hospital established in the colonies was in New York City, then known as New

Amsterdam. In I658, at the suggestion of a Dutch West India Company surgeon a hospital was erected for the care of sick soldiers, who previously had been billeted in private families, and for the company's negro slaves.

The first comprehensive and successful attempt to establish a general hospital was in Philadelphia towards the middle of the 18th century. Thomas

Bond, a Philadelphian physician who had studied medioine in England and was familiar with English hospitals, and Benjamin Franklin were its chief - promoters, Franklin obtained a grant of 62,000 from the Provincial Legi_s lature on the condition that a like sum be raised by public subscription in Philadelphia. This was done and the managers of the hospital rented a house and in it opened (l75l) the Pennsylvania Hospital, the oldest - hospital in the United States. Five years later they completed their new plant on Spruce Street on which site the Pennsylvania Hospital has been in continuous operation ever since.

Most early hospitals were established as charities for the poor and the homeless and for the isolation of persons suffering from certain - communicable diseases. Unfortunately, because of lack of knowledge of the causes of diseases, of the sources of infection and many of the simple principles of sanitation and ventilation, they were unable to protect adequately the health and lives of their patients. Early hospital surgery was fought with heavy mortality as was hospital obstetrics. Hospital fever spread by overcrowding and faulty ventilation, carried off many more - patients.

With the discoveries of Louis Pasteur and Joseph Lister there came about great changes in surgical technique, with increasing safety to surgical patients in hospitals. The discovery of methods of anesthesis still further prometed surgical practice and developed and increased - demand for hospitals, As modern medicine developed, increasing knowledge of the causes of diseases, improved methods of diagnosis and treatment, and the techniques essential there to hospitals became organizations of facilities by means of which the knowledge and skill of physicians, raade more effective by the service of trained nurses and technical personnel, were brought to bear on the problems of diagnosis and the care and - treatment of the sick, Hospitals became institutions for the practice of modem scientific medicine for the acutely ill rather than for the cus- todial care of the homeless chronic sick, This led to a great increase in the number and variety of hospitals, for as specialization in medicine developed there came a demand for special hospitals; in more recent years however, the development of iarge general hospitals with many special departments has tended to lessen the need for special hospitals. The

Bureau of the Census reports that there were in 1939 in the United States

6,991 hospitals and sanatoriums with a total bed capacity of 1,186,262 and

63,627 bassinets, In 1939 these institutions adraitted 9,627,000 in-patients

and gave them a total of 355,145,000 days of care exclusive of care of the

newbom,3 5 As recently as 1942-43 hundreds of plans for hospitals and some for matemity hospitals were submitted to the War Production Board with - requests for priorities showed little or no understanding by the architect or hospital administrator of the functional aspects of hospital planning and operation. During the war years Dr, Vane Hoge, Marshall Shaffer, -

August Hoenack, George Ivanick and Neil McDonald in the U.S. Public

Health Service set up a long range plan of cooperation between their group and private architects, hospital consultants, administrators and department heads. The oiåginal work of the group of crusaders was centered on improving the design of hosoitals to be built under World War II's Lanham Act.

Suggestions made by the Public Health ServLce in 1942-43 soon proved their worth in the steady improvement in plans submitted to the Hospital Division of W.P.B. during the last part of 1943 and on through the life of W.P.B.'s priority system.

During the past seven years, the Bureau of Medical Services of the -

U.S. Public Health Service under the direction of Dr. Jack Mazur, and its

Division of Hospital Facilities and Medical and Hospital Resources \inder the respective directions of Drs. John W. Gronin and John R. Mcgibony and

Marshall Shaffer have carried on a continuing research program on the - function and the design of a modem hospital. PROJECT STATEMENT INTRODUCTION BACKGROUND STUDIES GOALS a OBJECTIVES "All children shoxiLd be tirelessy, noisy,

playful, grubby - handed except at raealtirae s

soiling and tearing such clothes as they need

to wear, bringing not only the joy of child

hood into the house but the dust and mud as

víell; in short everything that makes the -

qiiiet and order of sickness and nursing

impossible" George Bemard Shaw

The main objective of the proposed children's hospital is to create an environmental space sioitable for the children's psychological well being during medical treatment, The aura of the building raustcoincid e with that of the children, fulfilling their particular needs.

The child's needs are special; his own personal scale is different from that of the adult, Soraetimes even children's diseases are different and require special treatment with special facilities. The child needs a unique place, a place or facility created specifically vn.th him in mind,

The children's hospital is an institution for the reception, care, and medical treatment of the sick or injured child. The care of such a child is its primary function, The first requisite for his care is that he be

8 properly accommodated. Three factors can be considered in fumishing - accommodations necessities: (a) The physical condition of th. child; (b)

His parents social or financial status; (c) His age group. As far as the physical condition of the child is concemed, patients will be classified as seriously ill or not - siriously ill, those whose illness does not constitute a threat to others. The seriously ill child or the child suffering from a disease that causes a menace to others should have indi - vidual rooras or isolation quarters. Those not seriouslly ill raight prefer company from other children. For these, patient wards of two or more beds are suitable,

The hospital must be able to accomodate patients whose parents have varying social economic status, Well-to-do parents raaydesir e privacy for their child and are able and willing to pay for it. Rooms affording privacy should be available. For the patient with parents of moderate - means, small wards containing from two to four beds are often desirable and more economical. The third factor is the separation of children by age groups. The patients would be divided in three categories: infants

(0-12 months), toddlers (1-5 years) and school children (6-12 years).

There are others responsibilities that the hospital has to fulfill to provide adequate care of the sick child. Maintenance of the hospital is a major consideration. It is not - sufficient that the building be kept in a good state of repair, It must also produce a pleasant, neat appearance for the patients' mental and physical comfort, Adequate facilities for the Maintenance-Housekeeping,

Responsibility of the hospital must be provided keeping the hospital clean is not and easy task, Part of the problem is that the hospital is an active place, open 24 hours a day, A clean, well maintained hospital is preceived to be a well-organized and well-designed facility,

Provision of proper facilities for diagnosis and treatment is another consideration, For the patient requiring surgery, operating rooms are necessaiy, It is also the duty of the hospital to incorporate such adjunct facilities as a departraent of radiology and a clinical laboratory, Physical therapy is being used to such and extent in the rehabilitation of patients that every hospital should have provisions for these services,

Another important responsibility in the care of the patient is food service, The time has passed when only a good chef is sufficient for the patients' nutritional needs, The dietitian has taken the place of the chef,

The dietitian rausthav e a well-designed kitchen in order to perform the task assigned to this department, On the other hand, the kitchen's function 5 must coordinate with the function of the whole hospital,

]0 The heart of the hospital is the administration, The administrative

Department coordinates all activities of the hospital, Primary considera tion must be given to the design of this department,

The medical staff is the chief agency through which the hospital - achieves its prime purpose, that of the proper care of the sick and injured

This position of iraportance does not, however, make it supreme and independent wittiin the hospital, Both the governing board of the hospital and the community which it represents exercise effective control over it. A well- planned organization of the medical staff is essential in order to perform its duties,

Imagination and practicality must be used in order to design a useful and beautiful hospital, while at the same time satisfying the needs of the must important clients, the children, To a extent this is what will also help determine the Architectural design of the hospital. To fulfill that objective certain children's needs have been listed:

1) Make the child's arrival to the hospital pleasant, simple and direct

from family car, taxi or ambulance to the hospital.

2) Provide a separate entrance for the seriously ill and those not

seiåously ill. 3) Encircle the child with interesting and comfortable surroundings

to keep his mind occupied whenever possible.

4) Reassure the child that he has not been forgotten.

5) Provide easy access between child and parents.

12 Project Purpose

The purpose is to create an enviromental space more suitable for the children's pschological well being during medical treatraent. The children's hospital should provide the city of el Paso and its surrounding communities with the most efficient, complete, modem and pleasant health care available, specialty for children, at a reasonable cost. LOCATION MAP The location of EIL Paso and Cd, Juarez relative to its location surroundings states of the Araerican Southwest and Northern Mexico are shown on raap above.

14 THE HOSPITAL FOR THE COMMUNITY

The design of a hospital is a complex matter, Natural conditions of site and climate modify design, as do technical constraints of structure mechanical systems, methods of coramunication, legal restrictions, and - available money, Together these factors help determine the form of a pediatric facility, But these reqiiirements should not pressure the designer to ignore the image that the hospital presents to the comraunity,

Despite the growing number of altematives in medical care facilities

and systems, the need continues to hospitalize some children on both short

and long-term bases. The treatment of many congenital disorders, metabock problems, accidents, and surgical conditions requires the speciallized

environraent of the hospital. Types of hospitals will necessarily vary,

depending on the types of care given. Sorae hospitals are geared for acute

illness, while others specialize in rehabilitation or long-term care. A

children's hospital differs in various ways from a general hospital with a

pediatric unit.

Even before a child enters the hospital, he has an iraage of it. If

the hospital looks like a fortress, he can iraagine being locked up there,

and he reacts with fear. This kind of irapression represents a major problem

of modern institutions.

15 Only by organization can efficiency be produced, No minor detail should be neglected, yet there raustb e no overlapping; every individual should have definite space assignraent, The approach to the design problera will be twofold.

One part is the application of knowledge and experience frora already existing facilities. The second is the incorporation of good design ideas from - children, since the design will focus on their special needs,

The children's hospital is a great asset to the community of El Paso because, in-spite of its being a metropolitan city of 451,462 inhabitants, it has no facilities specially for the health care of children at present. The Building

Even though the children's hospital would be a complete, autonomous institution consisting of 100 beds, not all specialized facilities would be part of the design. Equipment and staff from Eastwood Hospital, which is located across the street, will be utilized, and the existing motels nearby, Provide accomodations for out-of-town patients and their parents.

These factors combined make the site a suitable one. For futher details on the site description refer to site analysis.

17 PROGRAMMING GOALS

-To create spaces conducive to the emotional well-being, as well as

the physical v/ell-being, of the children of El Paso and its surround

ing communities.

-To conserve space, but not at the expense of efficiency.

-To facilitate accessibility to the handicapped. Handicap coramodities should be an integrated part of the program and design.

To achieve the greatest efficiency in the facility's operation throuj-a good planning prograras.

To corapleraent the general upbeat nature of the community.

To take advantage of the climatic conditions for an energy-efficient building.

To encircle the child vri.th interesting and comfortable surroundings to keep his mind occupied whenever possible.

18 PR OGRAMMING OBJECTIVES

These objectives suggest standards in order that the final design proposal can be evaluated and are used to guide the design propess in a

directional manner.

-To make the child's stay, as well as the arrival, pleasant.

-To make the facility, as an architectural stateraent, a positive -

urban eleraent.

-To comply with city and hospital regulations.

-To create a harmonious relationship between the hospital interior/

exterior.

-To incorporate imagination and practicality in designing a useful

and beautiful building.

19 JMR /"<

ACTIVITY ANALYSIS

ZtO EL PASO. TEXAS GENERAL DATA i

(EL Paso Area Fact Book, '81-82 edition, figures are based for 1980-81 year)

Gommerce: Retail Sales $1,743,707,000

Whole sale trade $1,317,466 an increase of 23.5^ from previous

year,

Building perraits: $255,989,624

6,262 perraits,

Bank Deposits: $1,636,147, 23 Banks

Saving & Loans Deposit; $507,620,229

International Trade: exports exceed iraports

Exports: $1,753,800,000 (a plus figure)

Iraports; $1,497,200,000

Households Incorae Group

$ 0 - $7,999 21,6/0

$8,000 - $9,999 6,4/5

$10,000 - $14,999 17,1/0

$15,000 - $24,999 28,7/»

$25,000 - and over 26,2^

Transportation: Federal Interstate Routes:

1-10, 1-110, and 1-25,

Transcontinental Highways;

U,S, 54,62,30,85,180 and 45 to Mexico,

Local highways:

Loop l6j 375 20 liOcal freeways; North-South, Border and 1-10 freeway.

Tmck Transportation; 25 raotor freight corapanies

Railroads; 5, Santa Fe, Southern Pacific Co., Missouri

Pacific, National Railways of Mexico, and Chihuahua -

Pacific Railroads,

Bus Service; Scat city. Intercity service; Greyhound,

New Mexico, Scat, Texas, and Trailways to Mexico,

Autobuses Internacionales, Flecha Roja, and Transportes

Chihuahuenses,

Air Transportation: AÍCTíays, American, Continental, -

Eastem, Frontier, Southwest and Texas International

Airlines,

Auto visitors: 19,340,000

Comraunication; Mountain Bell serves the entire El Paso Area víith tele-

phone services,

Radio: (AI-l) KAMA, KELP, KHEY, KISO, KOL, KROD, líSET, KTSM

and XEZOL,

(FM) KAMA, KEZB, KFIM, KHEY, KINT, KLAQ, KLOZ, KSET,

KTEP and KTSM,

Television; Channels 14,13,4,9 and 7 t^rith addition of

channels 2 and 5 frora Mexico (cable television is available) Newspapers: El Paso Tiraes, El Paso Herald - Post and

El Fronterizo (Mexican Paper),

Culture;U,T,E,P. University of Texas at KL Paso (11,000

students), El Paso Community College (6,000 students),

Moseum of Art, Civic Ballet, Civic Center, Library, and

Amphitheater,

Area; El Paso County 1,054 square miles

City of El Paso -240 square miles,

ELevation is 3,762 feet,

Governraental Units; 12 Incorporated Cities, 9 school districts, 1 hospital

District, 1 comunity College district, and 1 Fire -

Prevention District,

Labor Force: The total iabor force is 175,558. Ehployment is l6l,900

persons and unemployment is 13,650, A rate of uneraployment

7.8^. In 1980, the unemployment rate ranged betiireen 8.2/

and 10,3/. Of the total labor force the annual average

is 9,3/, The number of uneraployed has been increasing in

the past years.

22 HISTORY - EL PASO. TEXAS

In 1581 the Rodriguez/Charauscado expedition visited the El Paso area and crossed the Rio Grande near EL Paso (the pass). In I659 the first - permanent European settlement was established in the El Paso Valley and the Mission of Guadalupe was erected, The mission still stands on the

Central square of Juarez, In I68O, Spanish colonists were driven out of

New Mexico and accompanied by Tigua Indian refugees in I68I settled in -

Ysleta within the present l Paso city limits. A trading post was erected in Gentral El Paso in 1848 and the same year, a United States military post that was to become Fort Bliss was created. The first railroad trains pulled into El Paso in 1881. EL Paso commemorated its four centuries 81 quadricentennial in I98I,

GENERAL INFORMATION

The city is strategically lo.Gated to reach the grovd.ng industry of the southwest as well as both the east and west markets, Water supplies are

adequate to meet the city's needs. El Paso is at the extreme .western tip of

Texas, The city's population of 431.462 makes it the largest city in an area bounded by Los Angeles on the west, Denver to the North, Mexico City to the

South, and Forth Worth and San Antonio to the East, In other words, it is more than 600 miles to a city or the same or larger size, The EL Paso is the

Commercial, financial, cultural and transportation center of a major portion

of the Southwest,

23 El Paso is the largest city on the Mexico-United States Border, Its neighboring city Juarez, immediately across the Rio Grande, to the South, is the largest city on the Mexican side of the border víith its population of 700,140. The more than I5 million bridge crossing which are made -

annually give some indication of the economic and social ties of the two

cities.

Fort Bliss, Biggs Air Force Base and William Beauraont Hospital are

also part of the city of El Paso. Thousands of railitarypersonne l and -

their families also contribute to the economic and social activities of

El Paso.

EL Paso and Juarez, together vjith persons living in the metropolitan

area, form a population center in excess of 1.131.602 people. The residents

of the area enjoy the flavor and activities of two nations.

Housing is plentiful for all economic levels. Residential areas are

dotted vd-th dozens of New sub-divisions of raodern,attractiv e homes.

Educational facilities ranging from kindergarden through college are

available to El Paso residents. The public schools are modern and progessive.

24 The University of Texas at EL Paso Texas (U.T.E.P.) provides complete training in engineering and liberal Arts includlng graduate degrees in many fields with students at the college now nurabering 11,000. El Paso Coraraunity

College has. 6,000. '^

Moderate cliraate makes living in the city pleasant throughout the year.

People are able to participate in outdoor activities such as tennis and golf. Industries find the climate to be extremely advantageous because - heating and cooling cost are low due to high but not extreme daytime summer temperatures, low humidity and mild winters.

POPULATION TRENDS

One of the prime considerations in the design of a hospital concerns expansion, How much expansion can be expected and how much room should be alloted fbr it can only be answered after studing the population trends for both the immediate area and the region.

In order. To predict the population grow into the future, it helps,

to look at how the population has grown in the past and what has affected

25 that growth, Below is a chart that projects KL Paso'a growth.

Source;U.S. Department of Comraerce, "Gensus of Population and Housing 1940-1970" Bureau of Census & "Advance I98O Preliminary Census Counts" Departraent of Planning, Research & Developraent Projections 1990-2000 Secretaria de Industria y Comercio,"Censo General de Poblacion de Los Estados Unidos Mexicanos 1900-1970"

1,400

^ .^ ^ ^ 1,200 ^ 9po,6bo

1,000

i eoo

700,000 y

0 ,000 600-

L'Í79,48 3 436,094 Jt / y' ^42S,I24 400 ^3^9,291 314,070 "''/'''''-' "^322,261 278,7^'^^ 'y [ 276,687 y' y ^ -'ij»4>ée •"l3l,308^-j PI30,48B

1940 1950 1960 I9TO 1980 1990 2000

26 POPULATION NUMBER OF INHABITANTS

City of El Paso EL Paso County (SMSA) State of Texas

1900 15,906 / 24,886 / 3,048,710 / 1910 39,279 / 52,599 / 3,896,542 / 1920 77,560 / 101,877 / 4,663,228 / 1930 102,421 / 131,597 / 5,824,715 / 1940 96,810 / 131,067 / 6,414,824 / 1950 130,485 / 194,968 / 7,711,194 / 1960 276,687 / 314,070 / 9,579,667 / 1970 322,261 / 359,291 / 11,198,655 / 1975 *360,725 / *400,971 / **12,237,000 / 1978 *382,754 / *431,826 / **13,014,000 / 1980 425,259 / 479,899 / 14,228,383 / 1981 *431,462 / %86,702 /

S0URGE:Gensus of Population & Housing, *SL Paso Chamber of Commerce estimates, **U,S, Bureau of Census estimates

POPULATION OF EL PASO BY PLANNING AREAS 1978-1979

December 31,1978 December 31),197 9 Population Percent Population Percent

Northeast 75,521 18.42/ 79,000 18.82/

Northwest 41,951 10,23/ 44,200 10.53/'

Gentral 134,871 32.89/ 133,500 31.81/

Southeast 71,258 17.39/ 74,500 17.75/

Lower Valley 86,399 21.07/0 88,500 21.09/0

410,000 lOO.OC^o 419,700 100,0(^í

27 AGE TRENDS OF POPULATION:

Age & Sex distribution by planning Area 1930: (Percent)

Male Lower Valley Central Southeast Northeast Northwest total Gity

0::^ 8,6 8,3 6,2 5,9 6,8 7,4 ^ 7.5 6,6 9,6 8.1 10.6 8,1 10-14 11.5 10.9 11,0 11.1 9.8 11,0 15-19 13,4 14.4 12,8 13,4 10.6 13.4 20-24 8,8 15.3 6,7 10,7 12,8 11,3 25-34 16.1 14,4 18,6 13.0 16,2 15,5 35-44 12.1 9,2 14,2 13.8 12,8 12,0 45-54 8.6 10,0 10,6 10,7 10,2 10,0 55-64 6,7 7,0 6,7 8,5 6,4 7,1 65 or over 6,7 3,9 3.7 4.9 3.8 4.6 Median age 25,1 23,2 27,0 25.6 24.9 24.9

FMALE

0-5 9,3 5.7 8.4 7.0 6,8 7.3 ^ 12,3 9,6 7.4 7,9 9,5 9.5 10-14 12,3 6,1 é.4 12,1 8,6 9,5 15-19 12,3 12.7 12,5 11.7 12,3 12,4 20-24 6,2 17,0 16,2 8,9 6,8 12,1 25-34 16,5 14,8 17,0 12,6 22,7 16,0 35-44 13,0 9,6 15,0 16,4 13.2 13,0 45-54 8,6 12.7 8,1 13,6 10,9 11.0 55-64 6,9 6,6 6,1 4,7 6,4 6.2 65 or over 2,5 5.2 2,9 5.1 2.7 4,0 Median age 23,1 24,7 24,9 26,9 27.6 24,7

28 ECONOMY

El Paso's economy can be described by a regional economic grovrbh theory knovm as the economic base theory. This theory divides regional

econoray into two sectors.One is the export sector that produces goods which are raainly consumed outside the region, and whose growth Dr.Level of activity is largely determined by what happens in the national econo my. The other is the service sector which produces mainly for local con sumption, and whose grovíth and economic well being depends primarily on S the success of the basic industries.

The city of El Paso is moving toward a better economy. Moreover, as the six aldermanic district's representation indicates, a new awarences of community has into the various areas of the city. Neighborhoods are soliciting information and contributing ideas to new development recogni- tion of environmental effects. Transportation studies, including international transportation, have been conducted delineating interesting - transit alternatives new land has been added to the city liraits on the northeast and northwest,

The city of Juarez has completed a dovmtown development plan of its own that will affect the life of dovmtown El Paso. A partial beautification

29 project of EL Paso's central. Business district has been corapleted, such

projects had helped in the cash flow. Border crossings would be an

indicator 38,864,377 people croosed across the border, this indicates

the economic dependency of El Paso and Cd. Juarez upon each other.

Cash flow between these communities is extensive and the economy of

each city is to a major degree dependent upon individuals traveling -

between the two cities to exchange their dollars for goods and services

or to exchange services and goods for dollars.

The future expansion of the city will take place in the northwest

towards Las Cruces; the slopes of the Franklin Mountain Range vd.ll be

habitated by a middle .class population with some blue-collar workers;

in the upper valley, an upper middle class of executives and professionals

will reside,'^

The city of El Paso has experienced healthy and stable economic grovrth

since 1970. Continued and sustained grovrbh is expected in EL Paso,

EL PASO TRADING AREA.

The el Paso Market Area Map shows the potential market area. Surround- ing EI Paso, An intemational population of over 1,800,000 persons.

30 located within 200 miles of the city, relies on EL Paso as its trading center, and three million persons reside líithin a 3'00 mile radius, Major population centers in an approximate 700 raileradiu s include San Antonio,

Houston, Dallas/Fort Worth, Oklahoraa City, the Texas panhandle Amarillo

Lubbock area, Midland/Odessa, Denver, Phoenix, Tucson, Albuquerque, San

Diego, Los Angeles and Northem and Gentral Mexico.

31 EL PASO REGIONAL TRADING AREA MAP

32 HEALTH FACILITIES AND SERVICES

E1 Paso is a major health and medical care center for the Southwest, providing up to date specialized medical services to west Texas, southem

New Mexico and northwern Mexico as well as the immediate city and country area. Studies by the West Texas Health Systeras Agency show that 2C^ of the patients in El Paso's hospitals reside outside of El Paso County.

EL Paso's first hospital, Hotel Dieu (French-House of God), was founded in 1892, today EL Paso has one public and 14 private hospitals vdth a total capacity of 2,286 beds. Víilliam Beaumont Army Medical Center, 483 beds not included in the civilian hospital figures, is one of the largest U.S. army general hospitals and sejrves near-by military installations, veterans, and retired array personnel. El Paso Cancer Treatment Center, opened in 1974.

One hundred and thrty one dentist offer general dental care and specialist service. Well organize public health services are established in the county under the state directed city-county health Departments.

The city ratios are; doctors to population, one to 901; dentists, one to 3,293; and hospital beds, cne to 189. SMSA ratios; doctors is one to l,0l6 dentist, one to 3,715; and hospital beds, one to 176.

33 EL PASO'S SOUTHEAST GROWTH

MONT W OOD - EASTSIDE A R EA

The Montwood- Southeast area is currently traversed frora north-to-south by four main arte.rLes: McRae Boulevard, Wedgvíood, Drive, Yarbrough Drive and

Lomaland Drive., Lee Trevino Drive run^ortk and soutli on the eastem - perLphery of the area and intersects the border Highway at the Zaragoza Port- of-Entry into old Mexico.

The population in the three census tracts comprising the Montwood -

Southeast area is conservatively expected to contribute at least 2C^ of EL

Paso's total population grovrth frora 1970 to I98O,

The income occupational and educational level of the population of the

Montwood Eastside area is higher than the rest of EL Paso, Roughly 36/ of this population is employed in managerial categories, and the mean family

34 income is approximatery 44/ above that of the rest of El Paso,

The quality of homes in this area is extremely high, Future development of the master-planned community conteraplates additional handsome living units, modem schools, attractive office buildings, convenient -

shopping facilities and recreation centers,

Comraercial activity in the area is well established, appears profita- ble overall, and it expanding to raeet the needs of a steadily increasing

and relatively affluent population,

The grovrt-h of the Montwood Southeast Area is expected to continue, and most likely accelerate, There is a considerable amount of vacant land available for development, The area is active dynamic and moving svíiftly toward a prosperous futiire,

Transportation;

Public transit within the City of El Paso is provided by the city opera ted bus line, Sun City Area transit (SCAT), Service was improved signifi- cantly in 1978 when advanced design buses were placed into service, Curently,

Scat provides service on 24 routes and carries over 7.5 million passengers per year, Refer to bus Routes for the Montwood Eastside Area Map,

35 HOSPITALS IN THE EL PASO AREA ••

*Diablo Hospital - Northeast El Paso -Short-term hospital, general surgery

clinic and 24 hour eraergency room víith doctor living on premises,

Eastwood Hospital-East El Paso-Full service raedical and surgical hospital víith services including ICU/CCU, pediatrics, 24-hour physician-staffed

emergency room and cardiovascular surgery,

*Family Hospital -South EL Paso- Mostly gynecological services, including

birth control and deliveries.

Highland Park Hospital -Central El Paso- General medical and surgical

hospital. Outpatient prograras include the Cardiac Rehabilitation Center,

the Pulmonary Rehabilitation Genter, and the Stroke Rehabilitation Center.

Hotel Dieu Medical Center-Dovmtown.' A catholic not-for-profit general

acute care hospital operated by the Daughters of Charity. Services

include 24-hour physician-staffed emergency room, cardiovascular sur-

gery, Renal Dialysis Center, and porta-tel for the hearing impaired.

*Newark Methodist Matemity Hospital -South EL Paso- OB/GYN Hospital.

Providence Meraorial Hospital -Central El Paso-A not-for-profit coraraunity

hospital offering a full range of services including a fuH-service physical

medicine and rehabilitation center, perinatal center, heliport, complete

cancer treatment center and 24-hour physician-staffed emergency room.

Sierra Medical Center -Central EL Paso - General acute care hospital.

Service include 24-hour eraergency roora, prenatal and care of the new-

36 bom classes, enterostoraal therapy, acute heraodialysis, porta-tel services

for the hearing impaired and heliport.

*South El Paso Hospital -South EL Paso- 99/ of services are raaternity.

Southwestem General Hospital -Central EL Paso- General acute care hospital. Additional services include a i6-bed alcoholisra recovery center, oncology, pain and stress therapy, and birthing room. Eraergency Care

Center is in Mortheast El Paso at Transmountain Road and Dyer.

Sun Towers Hospital -Central EL Paso - Medical and surgical hospital. Serv- ices included Heart and Vascular Center, 24-hour, physician=:staffed emergency room and burn care unit equipped for all types of burn injuiies.

*Sun Valley Hospital - West El Paso - Private Psychiatric Hospital -Alcohol and substance abuse treatment prograra for adults and adolescents and psychiatric eraergency services. Some raedical sexTílces available.

R,E. Thomason Gteneral Hospital -Central EL Paso- Public General Hospital

Full service acute care inpatient services, 24-hour physician-staffed emergency roora and many outpatient clinics. Primary teaching hospital for Texas Tech University Regional Academic Health Center. Legal responsibility for providing care to indigent County residents.

*Tigua General Hospital -East El Paso- General acute care hospital. All service- 0B,0R, 24-hour eraergency room with doctor available, lab, physical therapy.

37 physical therapy.

*Ysleta General Hospital -Lower Valley- Various services including an eraergency roora, but doctors must be notified.

William Beaiimont Army Medical Center -Northeast El Paso - One of the

Army's major treatraent, training and research centers. Full service medical-surgical hospital. Services include 24-hour physician-staffed emergency room and trauraa center, outpatient clinics, and heliport.

*Sraaller Hospitals also serve as resource for the EL Paso Area.

NOTE : *Refer to Hospital's location raap for Hospital's Location.

* El Paso has no facilities specially for the health care of

children.

38 HOSPITAL LOCATION

1. HOTEL DIEW

2. PROVIDENCE MEMORIAL 3. THOMASON GENERAL

4. SUN TOWERS 5. SIERRA MEDICAL 6. ST. J03EPH 7. SOUTHWESTERN

8. EASTWOOD

9. TieUA 10. VSLETA 11. HIGHLAND 12. WILLIAM BEAUMONT

39 • ir^wtf; .^mJlL

ACTIVITY ANALYSIS

w DEPARTMENTAL INTERRELATIONSHIP TRAFFIC PATTERN AND ADJACENCIES

Today patient -Care functions are subdivides into the medical, administrative, and service groups. Each of there employs a variety of different types of personnel, but the entire staff of the hospital has to work as a team.

The primary go.al in any hospital is to make the patient comfortable and to attend to his needs. Because of the size of the Hospital's staff, it is obvious that , achieving staff organization, coordination and relaxation is a difficult task.

(NOTE: All charts and activity descriptions taken from Job Description and

Organizational Analysis for Hospital and Related Health Services. United

States Department of Labor, Washington D.G., 1970 and 1980 editions).

41 PATIENT

Patients may be categorized into three distinct groups. Each has special physiological, psychological, and social needs which raust be considered in creating physical space for their hospital care. These three groups are as follows: infants, toddlers and school children.

Infants are children up to one year of age. They are priraarily establishing trust rezationships. Infants' needs include opportunities to develop coordination and other raotor skills, sensory stiraulation provided by the environraent, and physical care through loving personal contact. Infants raay be divided into two categories: Neví boms to seven months, and seven months to one year of age. This distinguishes the very young infant (0-7 months), who generally experiences no ill-effects from hospitalization and separation from his mother, as long as his needs for food, warmth, and love are raet by an adequate "raother - substitute". On the other hand infahts frora 7 raonths to one year exhibit more severe reactions. They show an initial protesting negativisra toward staff and subdued, withdravm behavior.

Toddlers and preschoolers (one to five years'0 are striving for autonoray they vd.sh to be independent but raay becorae afraid in the absense of their parent, They lack a proper ^capacity to judge tirae and tend to misinterpret things that are happening around them. It is iraportant for these children to continually test their physical skills, explore - their environraent, and be involved in play activities. A toddler left in the hospital feels betrayed and deserted. He is too young to understand the assurance that his parents will retum and that he vjill go home. A Three year-old in the hospital raay understand alittle raore when his parents

42 leave, but no words can overcarae his fears of being left alone or the anxiety he feels at the sight of hospital equipment.

School-age children (six to 12 years) are very industrious and are emerging from independence to social interaction, so school activities are important. Fears regarding disturbances of normal body function are high, He is less susceptible to accidents and requires much less careful supervision than do toddlers and preschool children, He forms his first close rautual friendships and learns to work in teams. Often he prefers friends of his ovm sex, In developing social relations, he learns to accept and adopt social and moral rule systeras. One task of the - hospital, therefore, raustb e to provide an environment that will allow the child to develop and practice. The vri.de range of physical, social, and cognitive skills that he needs to eventually archieve independence from adults, For the grade school child, hospitalization poses a threat of continued and regressive dependecy and of falling behind in the developraent of basic skills. Coupled váth this threat is a continuing fear of rautilationan d anxiety produced by the unkmovm and frightening aspects of the hospital environment, Nonetheless, children in this age group probably cope more favorably with hospitalization than do either younger or older children, They can usually understand and accept the nece- ssity of their hospitalization.

43 Patient care is the priraary duty of the hospital personnel, To further understand the needs of our clients, it would be helpful to go through the routine of being admitted to the hospital, The Patient's routine. is priraarly composed of the following, Procedures 1, Arrival at the hospital by car or ambulance. 2, Entrance on foot, by stretcher or v/heel chair (main or arabulance en - trance. 3, Admission interview (admitting departraent) 4, Arrive at the bedroora (elevator service, guide service, wheel chair, stretcher). 5, Disrobing and govming (by parents or raedicalstaff) , 6, Physical examination (in roora or elsewhere) 7, Diagnostic Tests,

44 SEPARATE ENTR*NCE

AMBULANCE ENTRANCE AMBULANT INFORMATION PATIENT DEPARTMENT

ADMITTIN6

EMER6ENCY

RADIOLOGY SUROERY PATIENT CARE BMR. EK6. EE6. OIVISIONS

PHYSICAL MEDICINE

DISCHAR6E

THE HOSPITAL PATIENT'S TRAVEL Upon corapletion of the diagnosis, the patient may be involved in one or more of the follovíing: 1, Surgical preparation and operation 2, Medication of all sorts 3, X ray therapy 4, Physical or occupational therapy 5, Psychotherapy 6, Social counseling 7, Health education

In every case, if he stays in the hospital more than a few hours, he is subjected to a detailed nursing routine including aid in 1, Feeding 2, Bathing and personal grooming 3, Voiding and evacuating 4, Taking temperature, pulse 5, Giving pills, liquids, hypodermic injections 6, Questioning . 7, Entertainment (visiting, recreational or t,v,j

45 LABORATORY

SURGERY

X- RAY

TRAFFIC PATTERNS, PATIENT CARE DIVISIONS

PATIENT'S DAY, Once the child is in his bed, his typical day may be similar to this: 7:00 Awakened and washed, Bed cranked up for breakfast, Temperature and pulse taken, (sorae patients go to X-ray, Bar, or surgery before breakfast), 7:30 Breakfast is served. 8:00 Bedpan, bath, fix hair, back rub. 9:00 Medication, and bloQd sample taken. 10:00 Linen changed. Go to X-Ray or physiotherapy or surgery. 10:30 Housekeeper cleans roora. 11:00 Visit from the doctor, resid.ents, and interns en raasse. 11:30 Nurse prepares child for lunch, 12:00 Lunch served 12:30 Nap 2:00 Sit up for an hour visitors 3:00 Medication

46 3:30 Go to X-Ray or physiotherapy. 4:00 Visitors 4:30 A visit from the resident. 5:00 General clean-up and preparation for dinner 5:30 Dinner 6:30 Bed pan 7:00 Visitors 9:00 Medication 9:30 Sleep. Medication dûring the night.

47 If the patient progresses satisfactorily, he is discharged and completes the follovd.ng procedures: 1. Dress and pack 2. Parents arrange for payment at administration desk 3. Leave hospital If the child dies, the follovíing steps are taken: 1. Removing of the body, 2. Arranging for the autopsy 3. Ministering the family 4. Retuming personal effects, 5. Settling the hospital bill,

Through all of these activities, the interior environment, teraperature light and the texture and color of walls play a raajorrole , since the client feels he is in unfarailiar surroundings. He sees the world from a supine position, an abnormal way to visit a place, So the task is to eliminate objectionable physical features and try at every opportunity to raake his visit as pleasant as possible.

48 MEDICAL STAFF

MEDICAL STAFF BOARD OF GOVERNORS

L__ ADMINISTRATION EXECUTIVE COMMITTEE MEDICAL STAFF

CHIEF RESIDENT

INTERNS RESIDENTS

ORGANIZATION CHART

The raedicalstaf f is responsible for all the professional medical activities of the hospital, Members of the attending staff agree to take certain Eesponsibilities, including attending monthly staff meetings. In retum they have a vote and a voice in establishing policies relating to medical care in the hospital. Departments the staff is organized into departments by services, which consist of the follovrLng: Medicine Surgery Pediatrics Psychiatry HOUSE STAFF In larger hospitals there is a staff made up of intems and residents. Interns spend a year postgraduate under the direction and supervision of various physicians. They assist in patient care but do not

49 assurae responsibility for any patient. There raay also be a staff of resident physicians, who have completed their intemships and have decided to do further study toward achieving certification in a specific specialty. Each resident is on call 24 hours a day. Specialty consultants may be called in from other hospitals. On sorae occasions, doctors in related fields of public health and preventive medicine vd.ll participate.

50 SURGERY FLOW CHART

SUB- OPERATING FROZEN STERIL'Z'G SECTION ROOMS LAB.

V r CLEAN-UP X SUPERVISOR ANESTHESIA SCRUB-UP ROOM "T INSTRUM'NT STOR., ST0RA6E, I STRETCHERS JANITOR'S , :LOS.

CENTRAL DOCTORS' NURSES' STERILIZIN6 LOCKERS LOCKERS SUPPLIEâ

I DOCTORS PATIENTS NURSES OTHER HOSPITAL AREAS

LE6END DOCTORS PATIENTS NURSES

ADJUNCT DIAGNOSTIC FACILITIES FLOW CHART

IN-PATIENTS I PHYS. RADI- LAB. THER'PY Oi.OGY E'K'G' PHARM- hBMR. ACY T OUT-PATIENTS a HEALTH CENTER PATIENTS

51 EMERGENCY DEPARTMENT FLOW CH A R T

AMBULANCE

OBSERVAT'N OFFICE , BATH L - EMERGENCY BEDS OPERATING RM

•y TO NURSING

OUT-PATIENT DEPARTMENT fLOW CHART,

ADJUNCT DIAGNOSTIC FACILITIES DRU6 DISPENSARY

CONSULTAT'N OFFICE

I STAFF

HISTORY LOCK'ERS

SOCiAL ADMITTING SERVICE

HOSPÍTAL APPOINT RECORD ^. WAITING TOILETS INFO. TEL. RECORDS

OUT- PATIENTS

52 EXECUTIVE OFFICE

BOARD OF GOVERNORS

ADMINISTRATOR

ADMINISTRATIVE ASSISTANT AOMINISTRATIVE ASSISTANT

MEDICAL STAFF - ASSISTANT ADMINISTRATOR, MEniCAL ASSI5TANT ADMINISTRATORS

The purpose of this office is to direct all functions of the hospital in keeping with overall policies established by the goveming board in order that objectives of service to the sick, advanceraent of knowledge and overall contribution to comraunity welfare can be achieved raost effectively, econoraically, and to the satisfaction of patients, employers and medical staff.

53 ADMINSTRATION

HOSPITAL

SUP'T HOSPITAL

CASHIER

BUSINESS

VISITORS PATIENT5 LEGEND — STAFF — PATIENT3 . . . VISITORS OEPÍlRTMENT FLOW CHART Administration Department Administrator The Adrainistrator directs and coordinates all hospital departraents, prograras all planning policies, and raakessur e patients receive the best medical care possible. In order to perform all these duties, the administrator keeps regular office hours, Assistant Administrator The assistant administrator assists in the administration and coordination of all hospital activities, He is in constant consultation with the administrator, The assistant administrator assumes all duties of the administrator when he is absent, Aesistant Medical Administrator The assistant Medical Administrator is responsible for directing and

54 coordinating all medical and related activities vãth the only exception being the nursing department. He advises the Administrator on most medical and adrainistrative probleras. He supervises the heads of the various Departments, initiates and directs staff conferences to discuss administrative and medical problems and those held for instructional purposes, He is in constant use of an office and supplies:and may periorn^ surgery at one tirae or another, Administrative Assistant The Administrative Assistant is responsible for the completion of work assignjTie.^+s dictated by the AdministratTr, and the collectinr, and accuracy of assembled data, He prepares statistical and other special reports, He keeps regular office hours and walks randomly throughout the hospital in his attempt to coordinate relationships between department heads, Administrative Secretary The Administrative Secretary assists the Administrator by perfo.TTnin;~ clerical work and small scale executive duties, She takes ^"'nutes of board, staff and executive comraittee meetings in shorthand, transcribes materials using a typevrriter, Asserables materials for reports to several professional associations, Maintains files of correspondence and related materials, Opens and sorts raail and answers routine correspondence on own initiative, She sits at a desk during most of the day, handles most office materials and equipment, She stoops .and bends when using files.

55 ADMITTING DE PARTMENT

CONTROLLER

ADMITTING OFFICER

ASSISTANT ADMITTING OFFICER

Purpose; Admit patients to hospital in accordance víith policies and regulations established by the goveming board and executive office in such a way as to promote good relationships vd.th patient, relatives, and medical staff.

ADMITTING OFFIC R Determines the eligibility and arranges the adraission of the patient into the hospital. Interviews patient or relative to obtain personal and financial data. Prepares records for admission, transfer and other required data. Supervises admitting office personnel. Sits behind desk most of working day, may assist patient with baggage, makes use of office - equipment and material.

A3SISTANT ADMITTING OFFICER Receives incoming patients for hospitalization. Interviews patient or relative in order to obtain identification and required data necessary for adraission, Collects initial payment or refers patient to credit office Stores patienfs valuable objects, Assigns patients to roora. Sits behind desk most of the time, may perform typing work, may help patient with luggage. Handles office raaterialan d equipraent.

56 CONTROLLER Supervises and directs accounting, admitting, credit and collection functions. Coordinates work of accounting department våth other departments. Sits at desk most of the day. Uses office equipment and supplies. Walks in a very liraited area, lifts and carries ledgers, stoops and bends to open drawers.

57 PERSONNEL SERVICES

ADMINISTRATOR

DIRECTOR, PERSONNEL ADMINISTRATION

TRAINING OFFICER

Purpose: Coordinates needs of the institution with those individual employees in such a way as to provide the coraraunity vri.th efficient hospital service, and to staff the hospital with qualified, well adjusted employees. Personnel Adrainistration Director Plans and adrainisters personnel raanagement prograra. Develops personnel record forms. Serves as advisor to executive staff. Sits behind desk during raost of the day. Uses office equipraent and supplies. H iployraent Manager Interviews and screens job applicants. Adjusts employee disputes and grievances. Holds regular office hours, walks randomly throughout hospital. Uses office raaterials and equipraent. Training Officer Assists in planning, organizing, and directing training prograras to orient eraployees in hospital policies and routines. Conducts orientation courses and organizes safety programs. Sits and walks randomly throughout working day. Handles office equipment and supplies.

58 NURSING SERVICES

Purpose: Furnish nursing care, as part of professional treatment, for the recovery and physical and mental well being of the patient.

Director of Nursing Organizes and adrainisters school of nursing to train professional nurses, directs and supervises nursing services concemed víith care of patients. Plans and conducts conferences and discussions víith administrative and professional nursing staff. Plans and directs orientation and in-service training programs for professional and nonprofessional staff. Keeps regular office hours plus walks throughout hospital at random. Assistant Director of Nursing Directs and coordinates administrative and nursing service activities or General Staff Nurse Renders nursing care to patients víithin assigned unit, Observes and reports symptoms and conditions of patients, Takes and records temperatures respiration and pulse. Administers medications and notes reactions. Sets up treatment trays, prepares instruraents and other equipraent and assists physicians víith treatment, Assists in administering highly specialized therapy víith complicated equipment, Maintains records reflecting patient's condition, raedicationan d treatraent, Bathes and feeds acutely ill patients, Handles and raanipulates equipment and instruments, Stands and walks most of the day,

General Head Nurse Supervises and administers nursing service of a single patient-care unit, Assists in orientation of new personnel to unit and in educational

59 and guidance programs for nursing personnel. Provides for nursing care of patients in unit and cooperates vrith other members of medical care team. Periodically visits patients to insure maximura care and to ascertain need for additional or raodifiedservices . Handles and manipula tes assorted instruments and equipment, Stands and walks during raost of the day,

Nurse Aid Assists professional nursing staff by performing routine duties in caring for hospitalized patients, Constantly standing and walking during work perLods, Turning, stooping, bending, stretching and lifting to assist patients, makes beds, moves equipment, and performs other related tasks, Handles delicate instruments and other related equipment,

Practical Nurse Administers routine services in caring for selected subacute, convescent and chronic patients, Assists nurse in care of the raore acutely ill. Handles instruments and equipment. Stands and walks during most of the day.

Orderly Performs routine duties in caring for hospitalized male patients. Shaves hair from skin area of operative cases. Arranges anesthesia - equipment near operating table, and assists in holding patient on table during administration of anesthesia. Arranges oxygen and portable x-ray equipment at patient's bedside, and keeps oxygen tent supplied vdth ice. Sets up fracture equipment and assists physician in putting on casts and braces. Gives eneraas. May adrainister catheterizations and bladder irrigation after instmction and supervised practice. Assists in bathing and -

60 dressing patients. Maintains dressing rooras in clean and orderly condition. Maintains adequate supply of hospital clothing for attending physicians. Bathes deceased patients, accorapanies body to morgue, and places personal belongings in mortuary box. Performs various services, such as washing and sterilizing instruments and other equipment, transfers mattresses to and from sterilizing roora or for sunning and airing; - collects soiled linen and returns clean linens; runs errands for patients and staff merabers; wheels patients to and from operating roora, x-ray roora and other locations in the hospital, Constant standing and walking during working periods. Turning, stooping and lifting patients and equipment. Handles and manipulates delicate instruments and other equipment. NURSE, STAFF,PEDIATRICS

Renders nursing care to hospitalized patients assigned to pediatric services.

PERFORMANCE REQUIREMENTS

Responsibility for; Knowledge of patient's condition at all tiraes. Providing pediatric nursing care according to physicians' orders and in confomance víith recognized nursing techniques and procedures, established standards, and adrainistrative policies. Recognizing and interpreting symptoras, reporting patient's condition to supervisor or physician, and assisting víith or instituting reraedial raeasures for adverse developraents. Studying trends and developments in nursing practices and techniques peculiar to pediatric services and evaluating their adaptability to needs of nursing duties, Assisting in teaching patient good health habits. Cleanliness of area.

Provides for child's physical needs; Bathes patient and assists with feeding, dressing, toileting, and putting to bed, Takes teraperature, pulse, and respiration, Gives raedications and such treatraents as eneraas, and throat, bladder, and ear irrigations, Cares for children in croup or oxygen tents. Provides special nursing care for preraature or ill newborn who have been transferred to pediatric unit,

Aids Physicians; Assists physicians with physical exarainations, intravenous injections, lumbar punctures, withdrawal of blood, and related treatments, Applie:s.' or removes dressings as requested.

62 KEY FLOW CHART-ACUTE HOSPITAL

NURSING

1 %'• 1 1 l 1 ADJUNCT SERVICE DIAGWOSTIC SURGERY f • *•• LAUNORY FACILITIES KITCHEN OININS RMS HELPS LOCKERS 1 1 NUR3E3 " 8T0RASE L - - ' MECHANC'L PLANT 1 r 1 1 1 I 1 1 1 1 • A 1 1 HEALTH OUT-PATIENT EMER- ADMINISTR'T'N 1 CENTER DEPARTMENT 6ENCY 1 1 1 1 1 1 : 1 PATIENTS 1 OUT-PATIENTS '' ^^^^^^ ' SERVICE 9TÍ IFF AM BULAN CE BATIENTS » a OF HEA LTti CEf(TE- f i VISITO^S HELP

NURSING DEPARTMENT FLOW CHART

PATIENTS SOLARIA ^OT J , ,—I—1_, Wrl^hSH UTILITY TREATMENT NURSE3 . WAIT'S LINEN TBILET FLOOR PANTR^ STATION UTILITY JAN.CL. CL. STAFF PATIENTS . FROM KITCHEN VI3T0RS

LE6END STAFF PATIENTS «.tSITORS

63 CLINICAL LABORATORIES DEPARTMENT

ASSISTANT ADMINISTRATOR

MEDICAL STAFF PATH0L06IST

•"1 MEDICAL TECHN0L06IST BIOCHEMIST HEMAT0L06IST BACTERI0L06IST SER0L06IST CHIEF

ASSISTANT BLOOD BANK LABORATORY TECHNICIAN TECHNICIAN

LABORATORY MEDICAL ILLUSTRATOR _i HELPER MEDICAL PH0T06RAPHER

Assistant Laboratory Technician Assists Medical Technologist by performing one or more routine laboratory tests and related duties in a clinical iaboratory. May make qualitative detex- mination of sugar in urine, by adding prescribed reagents to specimens and noting change of color coraparisons in a coloriraeterí or separate plasma frora whole bioDd, using a centrifuge machine, Prepares sterile media, such as agar, in plates, jars, or test tubes, for use in growing bacterial cultures. Incubates cultures for specific tiraes at prescribed temperatures. Cleans and sterilizes laboratory equipment, glassware and instruments. Prepares solutions, reagents, and stains following standard laboratory formulas and procedures. Maintains laboratory stock of chemicals and glassware. May collect specimens from patients. Sits and stands intermittently throughout working day.

64 Blood Bank Technician Collects and processes blood, performs transfusions, and makes blood tests related to operation of blood bank, Keeps records pertaining to blood donations and transfusions, Frequently walks to and from patients' rooms to collect blood speciraens and give transfusions, Sits and stands intermittently while performing various blood tasks, Reaches for, lifts, and carries relatively light laboratory equipment and raaterials,

Heraatologist Directs and supervises analysis and testing of blood speciraens, and interprets test results, Directs operation of blood bank, Trains and supervises Heraatology Technician in performance of blood test and microscopic analysis of blood smears, or makes tests and prepares materials for microscopic studies, Assists technicians with more difficult tests and analysis of unusual test results. Performs specialized or highly complex tests, Reviews and interprets test results, examines blood film slides and cultures under microscope and writes diagnostic reports, Supervises blood bank technician in collection, processing and dispensing of blood and blood plasma, May lecture to lay and professional students, Sits and stands intermittently throughout working day, Lifts and manipulates relatively ligh laboratory equipment,

Serologist Directs and superTrises preparation of serums used in treatment and dlagnosis of infectious diseases, and to confer immunity against these diseases, Performs or directs performance of laboratory tests to identify diseases, Trains and supervises Serology Technicians in collecting specimens from hospital patients, raaking sera by inoculation of laboratorj'- animals, and conducting serological tests, Writes diagnostic reports, Investigates

65 safety of new comraercial antibiotic products and accuracy of therapeutic claims, Directs iramunology tests and injections, Coducts tests to determi ne therapeutic and toxic dosages, May lecture to lay and professional students, Sits and stands intermittently throughout working day. Reaches for lifts, carries, and raanipulatesrelativel y light laboratory equipraent.

Pathologist Supervises and directs activities of Pathology Departraent. Assigns and supervises activities of departraent personnel. Directs training of resident physicians, intems and technicians assigned to department. Serves as consultant to other departraent heads and visiting physicians to interpret laboratory findings and assist in determining appropriate method and extent of treatment necessary.

Bacteriologist Directs and supervises cultivation, classification, and identification of microorganisms found in patient body fluids, exudates, skin scrapings, or autopsy and surgical specimens, Trains and supervises Bacteriology Technicians in colecting swabs and sraears from patients, preparing bacteiial cultures^ . aad studying - identifying bacterial growth under microscope, Assists technicians with more difficult cultures and analysis and studies and identifies less common bacteria, Writes diagnostic reports for approval by pathologist. May lecture to lay and professional students. Engages in research to develop new and improved bacteriological methods for discovering and identifying pathogenic organisms. Sits and stands intermittently throughout working day. Reaches for, lifts, carries and manipulates relatively light laboratory equipment.

66 FORMULA- ROOM WORKER

Prepares all infant formulas; Receives list of formulas to be prepared including ingredients and araounts to be included in formula of each infant. May sterlize eqviipment and utensils to be used. Prepares formula solution by mixing specified quantities of Ingredients, or makes up individual formulas in accordance with orders of attending physician. Pours formulas into feeding bottles and identifies each with appropriate label. Places nipples and protective covers on bottles and processes bottles through terminal heating equipment. After cooling, stores bottles in refrigerator or delivers them to nursery refrigerators. Washes used bottles and all utensils and equipment, Prepares forraula list for following day.

67 RADIOLOGY DEPARTMENT

ASSISTANT ADMINISTRATOR

MEDICAL STAFF RADIOLOGIST

X- RAY TECHNICIAN, CHIEF

X-RAY TECMNICIAN

DARKROOM HELPER

Radiologist Supervises and directs activities of radiology departraent. Assigns and supervises activities of all department personnel. Directs training of staff raerabers,intern s and technicians assigned to department. Serves as consultant to other department heads to interpret roentgenographic findings and assist in determining nature and extent of treatment necessary. May conduct experiraental studies on effectiveness and usefulness of new methods of roentgen-ray, radiura and radioisotope treatment. Provides radiological services for diagnosis and/or treatment of diseases: Makes roentgenographs for diagnosis or research purposes. Demonstrates by roentgenography, intemal diseases. Treats internal and extemal growths, malignant or benign, by exposing them to roentgen rays or by implantation of radium, using a radium needle. Treats specific mouth infections using radium gas. Performs presurgical radium and roentgen therapy. Sits and

68 stands intermittently throughout working day. Stoops, bends, and reaches when positioning patient for x-ray and radium treatment. Manipulates - medical instruraents, equipment, film and x-ray plates.

Chief X-ray Technician Supervises and directs activities of X-ray Technicians engages in taking and developing x-ray films, and assists in administration of x-ray therapy. Assigns workers to duties. Performs all duties of X-ray Technician Instructs students and assistants in technical aspects of duties, in x-ray physics and anatomy. Stands, turns and stoops while operating equipment and developing filras. Reaches for, lifts, and carries equipraent which is usally light, Handles eqiiipment, controls, film and chemicals, Assists patient into position,

X-ray Technician Takes x-ray photographs of various portions of body to assist medical officers in detection of foreign bodies and diagnoses of diseases and injuries, Positions patient under x-ray machine and re,gulates controls to expose filra. Develops and dries film. Assists in x-ray and radium therapy, Maintains record of x-rays taken, Stands, turns and stoops while operating equipment and developing films, Reaches for, lifts, and carries equipment which is usally light. Handles equipment, controls film and chemicals, Assists patient into position,

Darkroom Helper Develops, fixes and washes exposed x-ray film, Imraerses filra in chemical baths for specified periods of time, Hangs film on racks to dry, May prepare photographic solutions, (Note- The duties of this job may be performed by a

69 PHARMACY DEPARTMENT

CHIEF PHARMACIST

PHARMACY HELPER

Chief Pharmacist

Gompounds and dispenses medicines and preparations according to prescriptions written by physicians, dentists and other practitioners, Prepares and sterilizes injectible raedication raanufactured in hospital, and raanufacturer's pharmaceuticals, Furnishes information conceming medication to physicians, interns and nurses, Stands raost of the working daj'-, Handles and manipulates chemicals and chemical equipment. Walks, stoops, reaches for, lifts and carries relatively light articles.

Pharraacy Helper

Receives, unpacks and stores supplies, checks shipments against invoices. Delivers drug orders and runs errands. Washes bottles and glassware. Under direct supervision of Chief Pharmacist, assist xn preparation of various pharmaceutical preparations and in labeling bottles, Maintains card file record of purchases. Stands and walks most of working day. Lifts and carries cartons and drug orders which may be fairly heavy. Stoops, bends, pushes and pulls when cleaning area. Handles and manipulates chemical equipraent and glassware.

70 PHYSIATRICS DEPARTMENT

ASSISTANT ADMINISTRATOR

PHYSIATRIST

RECREATIONAL THERAPIST

Purpose; Assist in recovery and rehabilitation of mental, orthopedic, traumatic, and other patients, through physical means such as mechanical devices, constructive recreational programs and handicrafts.

Recreational Therapist Assists in planning, organizing, and directing recreati^'nal progra-n to provide patients with directed activities as an aide to therapy and rehabilitation. Participates with patients in various activities, such as games, sports, dances, and dramatics. Studies patients' reactions to various activities and prepares reports describing syraptoms indicative of progress or regression. May conduct programs of occupational therapy. Performs related duties such as supervising activities of recreation roora, issuing books, and newspapers, and narrating stories. Sits and wall

Closely observes each child's progress. Interviews parents to learn about faraily situation, what the child was like before illness, and his likes and dislikes; and shares this inforraation with others giving care to child, Becoraes parent substitute during child's hospitalization,

Makes available play raaterials which contribute to raeeting individual child's needs and provide opportunity for learning experience, Conducts, or assists in, nursery-school activities. If patient is carrying on school work, assists with studies by raaking available necessary books, equipraeht, and raaterials,

Assists parents in understanding illness of child, his physical and emotional needs, adjustraents required during recovery, normal growth and development, behavior patterns, and importance of family keeping in touch with child during hospitalization.

~~72 MEDICAL RECORDS~~

~~ASSISTANT ADMINISTRATOR~~

~~MEDICAL- RECORD LIBRARIAN~~

Purpose: Provide a central file of medical records compiled during treatraent of a patient, that will be used as a permanent record in the event of future illness, as an aid in clinical and statistical research, as an administrative tool for planning and evaluating the hospital program and as legal protection for the patient, hospital and physician,

Medical Record Librarian Maintains files of medical records of patients adraitted to hospital. Codes and indexes diagnoses, operations, and special therapies recorded in clinical histories, Maintains patient's name index, clinical record files and related index, Prepares periodic and special statistical reports. Abstracts data for case siimmaries and insurance reports. Supervises activities of a raedical record department. Sits at desk most of working day. Stoops and crouches to use files. Walks short distances about offices and hospital corridors. Handles and raanipulates office equipraent, such as pencils and typewriter.

~~73 SERVICE STAFF~~

The hospital service staff is coraposed of all raedicalpersonne l working in the hospital not including the medical staff. The service staff is subdivided into the nursing and technical personnel and adrainistrative and service departraent personnel. The service staff is under the direction of hospital administration, specifically the personnel director.

Functional relations of the hospital service staff include: 1. Persons who have direct contact with patients. Ambulance driver Adraitting clerk Reception clerk Volunteers Murse Nursing aids Students Orderlies Laboratory Technicians Research staff X-Ray technicians Medical records librarians Business office personnel. PT and OT therapists Social service staff Auxiliary workers Phone operators Cashier 2. Persons who have indirect contact with patients Dietary staff

~~Ih Housekeeper Janitors Laundry Adrainistrators Pharmacist 3. Persons who have little or no contact with patients Maintenance workers Plant operation personnel Purchasing agents Central store clerks.~~

~~75 SERVICE DEPARTMENT FLOW CHART~~

~~HOSPITAL n I MAINTEN- ANCE NURSES' LOCKERS MECH'N'C'L PLANT~~

STAFF <(r DININ6 (T LAUNDRY l-Z HELPS ZliJ LOCKERS HELP TTT DINING _J L CENTRAL KITCHEN FORMULA STORAGE BULK FOOO ROOM STORASE SPECIAL RECEIVINa OIETS CLERK I SERVICE ENTRANCE 'ÁND HELP I I LAUNDRY FLOW CHART

~~TO FLOOR FROM LINEN CLOS. ROOMS~~

~~SEWIN6 ROOM SQLED LINEN CENTRAL ^ ROOM LiNEN RM. u S0RTIN6 F0LDIN6~~

~~FLAT WORK EXTRACTIN6 IR0NIN6 65% WASHIN6 SHAKEOUT~~

~~• 6% 30% 5Z1 TUMBLINP PRESSIN6 a HAND FINISH'6~~

~~KITCHEN FLOW CHART~~

~~DAILY DELIVERY~~

~~FROM CENTRAL- STORE ROOM~~

~~DAY STORAGE, REFRI6ERAT0RS FOR MEAT. VE6S, FRUIT, DAIRY~~

~~SCULLERY MEAT \1E6. n PREP, PRER~~

~~IYER S KETTLES~~

~~BAKIN6 BRglLÉRS SALADS~~

~~STE/iMERS~~

~~SPECIAL COFFEE DIETS ETC.~~

~~SERVIN6 DISH OFFICE WASHIN6~~

~~TO PATIEOTS PERSONMEL DINING RN . FROM FROM PATIENTI3 DININS RM.~~

~~77 SITE ANALYSIS~~

~~78 LOCATION MAP~~

~~79 EL PASO VICINITYMAP~~

~~ALAMOGORDO~~

~~Hollomafi^ir/Force Base~~

~~TABLEOFDISTANCES / -' FROM TO MILrs~~

~~I Paso Las Cruces 40~~

~~1 Paso White Sands Hqs 45 Paso Hollomon AFB 8 1 CITY & COUNTY LIMITS MAP~~

~~ANTHONY~~

~~VINTON MONTOYA CANUTILLO~~

~~NEW MEXICO~~

~~MILITARY RESERVATION CITY LIMITS~~

~~AREA SQUARE MILES El Paso County 1,057~~

~~8] 82 MilitdTy H.esavatinn~~

~~y 5 A MEXICO EL PASO, TEXAS- DATA "One of a Kind" is the most appropiate way to describe the en-viro-níné.rî6íil~~

~~conditions throughout the city of EL Paso, Texas. The area's topographic~~

~~and climatic features are of a semi-arid nature, broken in-between by~~

~~montain ranges and cently sloping uplands. West of the city lies the~~

~~boundary between the United States and Mexico. The rio grande serves as~~

~~an intemational boundary and separates Juarez and EI Paso.~~

~~LOCATION~~

~~Franklin Mountain Range, which is oriented in a north-south direction~~

~~and attains a maximum elevation of 7120 feet, is the domnant land~~

~~formation in the city. The southem end of the range terminates within~~

~~the city limits of KL Paso, while the northern portions lie within the~~

~~state of New Mexico. As stated before, to the west is the Rio Grande~~

~~River, which enters KL Paso County at an elevation of about 3700 feet~~

~~and leaves the county some 60 miles downstream at an elevation of about~~

~~3500 feet (soil survey 1971).~~

~~84 CLIMTE~~

EL Paso's cliraate is relatively pleasant year round. The name "Sun City" is appropriate, since the sun has failed to shine only 33 days, in the last 16 years. The average temperature of 75 F year round ranging from 100 in the summer to 20 in the winter. July is the hottest month of the year, with the average high at 95 G and. the average low at 65 F The coldest month is January, with the average low at 30 F and, the average high of 55 ?• For more information refer to average Temperature chart. An average year will yield about 8 inches of rain líith the most falling in July (1.3 in. average) and the least in April (0.3 in average). Refer to precipitation chart for more information. One of the climatic problems in the EL Paso area is vjind. Strong vjinds come frora the southwest in the Spring, and since the area is desert with large amounts of loose sand, the winds cause massive dust storms, in the cold months. The wind blows prLmarily from the north; and in the Suramer and Fall, from the south and southeast. The average speed is 9.8 I-ÍPH. Refer to prevailing vãnds chart.

~~FOLIAGE The desert plains of the EL Paso area are essentially of sand soil, supporting yucca plants, greasewood and mesquite as the most visible forms of vegetation.~~

~~85 SOIL STUDY~~

Soil association of EL Paso have been reported by the soil conservation service (soil Survey,1981), There is bedrock close to the surface which makes stable gro\ind conditions for the foundations, These associations fall into five different catagories with the children's hospital being in the area of the Association (same as Hueco Bolson and the Ebcarpment Area).

~~1) Hueco-Wink association - Possesses a severe to moderate hazard of~~

~~wind blowing; has a moderatory rapid penneability which encoorages~~

~~a slow surface runoff; is mildly alkaline.~~

~~2) Bluepoint Association - possesses a severe hazard of wind bloi^âng;~~

~~has rapid permeability; is middly aUcaline.~~

~~3) Harky - Glendale Association - from recent deposits has high content~~

~~of lime; has moderate to very slow permeability; has been leveled~~

~~for it irrigation in all areas where it exists.~~

~~4) Del Norte - Canutio Association - Has rapid surface run off and is~~

~~excessibly drained; high content of lime exists in Canutio Series;~~

~~is moderately alkaline,~~

~~5) Tumey - Berino Association - has moderately slow permeability;~~

~~drainage is good to moderately good; is mildly to moderately~~

~~aldaline.~~

~~86 TOPOGRAPHY~~

Topography of the EL Paso area consists of three dominant features: the river valley, the raontains, and the desert plains. Land elevation in the area vary from 2,800 feet in the Rio Grande valley to 7,192 feet at the tip of north Franklin Peak in the Franklin Montains.

~~87 CLIMATIC FACTORS~~

~~YEARLY SUNSHINE~~

~~MEAN NUMBEE OF DAYS suimiss TO SUNSET Ío OF MEAN SKY COVER POSSIBLE SUNRISE TO PARTLY MONTH SUNSHINE SUNSET CLEAR CLOUDY (:LOUD Y~~

J 78 4.6 14 8 9 F 82 4.1 14 7 7 M 84 4.4 15 8 8 A 87 3.6 16 8 6 M 89 3.2 19 8 4 J 89 2,8 20 7 3 J 79 4.3 12 13 6 A 81 4.2 14 12 5 S 82 3.1 19 7 4 0 84 3.0 19 7 5 N 83 3.5 17 6 7 D 77 4.2 16 7 8 Year 83 3.8 195 98 72

~~Source: National Oceanographic and Atmospheric Administration/~~

~~National Glimatic Center, Asheville, N.C,~~

~~88 SOLAR ANGLES~~

~~DATE SUN TIME BEARING TRUE ALTITUDE~~

~~January 21 8:00 a.m, 56Q East of South ll^ 17„ East of South and 11:00 a.m. 32^ 2:00 p.m, 33o West of South 30^ November 21 5:00 p,m. 65 West of South~~

~~February 21 8:00 a.m. 64 East of South 19 11:00 a.m, 21 East of South and 2:00 p,m. 39 „ West of South 38^ October 21 5:00 p.ra. 73 West of South~~

~~March 21 8:00 a.m. 73 East of South 25 11:00 a.m, 27 „ East of South and 2:00 p.m. 47 „ West of South 47 September 21 5:00 p.m. 82 West of South 12^~~

~~April 21 8:00 a,m, 84 _ East of South 32' 11:00 a,ra. 38 East of South and August 65^ 2:00 p.m. 60 V/est of South 21 5:00 p.m. 93 West of South 19'~~

~~May 21 8:00 a.m. 93 East of South 35 11:00 a,m. 51 Q East of South 72 and 2:00 p,m, 74 West of South 61^ July 21 5:00 p,m. 100 °West of South 22^~~

~~June 21 8:00 a.ra. 97 East of South 38" 11:00 a.m, 60 °East of South 74° 2: 00 p.m, 80 West of south 62° 5:00 p,m. 104 West of South 24°~~

~~Deceraber 21 8:00 a,m, 53° East of South lO^ 11:00 a,ra. 15 East of South 32° 2:00 p.m, 31 West of South 27^ 5:00 p,m. 62 West of South O^~~

89 Precipitation: Rainfall in EL Paso averages 7.7 inches annually, and generally half of this amount is experienced during the months of July, August and September. Maximum recorded annual rainfall is 17.19 inches, in 1958. EL Paso will experience snowfall several times during the winter months, but rarely våll more than one inch remain on the ground for more than a day. Maxiraum seasonal snow recorded is a total of 14.7 inches in 1976-77-

AVERAGE PRECIPITATION (INCHES) YEAR JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV 1950 0.29 0,26 T T 0,10 0.11 3.57 0.16 1.32 0.94 0.00 1960 0.72 0.37 0,21 0,02 0,04 0,76 3.61 0,77 0,01 0.77 0.11 1970 0,03 0,55 0,47 T 0.71 0.73 1.41 0,41 1.01 0.68 T 1980 0,54 0.73 0,25 0,31 0,08 T 0.21 1.76 1.90 0.95 0.54

~~Mean 0,44 0,41 0,33 0,24 0.34 0.59 1.67 1,43 1.28 0.81 0.43~~

~~YEAR DSC. ANNUAL 1950 0,00 6,75 1960 1.73 9.12 1970 0,06 6,06 1980 0,04 7.31~~

~~Mean 0.49 8,46~~

90 AVERAGE SNOWFALL (INCHES) SEASON JULY AUG SEPT OCT NOV DEC JAN FEB MR 1949-50 0,0 0.0 0.0 0.0 0.0 T T T T 1959-60 0,0 0.0 0.0 0.0 0.0 T T 2.1 T 1969-70 0.0 0.0 0.0 0.0 6,0 1.9 0.3 1.7 T 1979-80 0.0 0.0 0.0 0.0 0,0 0,0 T 3.6 0.0

~~MEAN 0.0 0.0 0.0 1.1 1,0 1.3 0.8 0,4~~

~~SEASON APR MAY JUNE TOTAL 1949-50 0.0 0,0 0,0 T 1959-60 T 0,0 0,0 2.1 1969-70 0,0 0,0 0.0 9.9 1979-80 2,0 0,0 0.0 5.6~~

~~MEAN 0,0 0.0 4.6~~

Wind; Wind in El Paso averages 9.5 MPH with a maximum recorded velocity of 70 MPH, Due to sparse vegetation in the region, windstorms generally produce blowing sand and dust. Windstorms are most common in March and

April. Wind over 25 MPH is experienced for 440 hours annually, a total of less than 19 days, although this experience is more extensive near the mountains, refer to prevailing víinds chart for wind direction.

AIR QUALITY:The Air in the el Paso area is relatively thin, due to the terrain's altitude above raean sea level and low huraidity. As a result, daytime sunligh is generally strong. Nights are clear and any particulate intrevsion in the atmosphere is visually visible.

~~91 SOUTHEAST AREA~~

~~The southeast area generally has a well planned environraent. The~~

~~housing stock is relatively new and in excellent condition. There is~~

~~an ample amount and variety of shopping, entertainment and professional~~

~~services. Streets and public facilities are relatively new and in good~~

~~condition. The planning Area is so new that there is no problem with~~

~~diadilapidates buildings, and no need for redeveloment of older areas.~~

~~Tl>e southeast area is expected to continue grovíing during the past~~

~~eight years. By the year 2000 the planning area vri.ll essentially be~~

~~fully developed, and íri.11 accomodate about 100,000 persons.~~

~~The largest single problem in the South-East planning area is the~~

~~shortage of comunity facilities. Population grovrt-h has been so rapid that~~

~~it has not been possible to provide services at the same rate of grovrth.~~

~~Consequently, the number of parks, health clinics, schools and hospitals 7 in the Area is below the City average.-~~

~~92 93 SITE-AERIAL VIEW sc. r-zoot ^:^^- SITE CHARACTERISTIC:~~

~~The site of the children's hospital will bein the Southeast portion~~

~~of the city. The actual site is sorrounded to the south by U.S. Highvray 10~~

~~and to the east by Eastwood Hospital, which vãll function as a supplement.~~

~~To the north are private residences, and to the west is a commercial~~

~~developraent.~~

~~The site is virtually flat except for a slight scope to the west and~~

~~up grade ot the south. There is no vegetation. The soil is mostly loose~~

~~sand, which, makes plant growing very difficult; therefore; it is advisable~~

~~for any landscape that the top layer of soil be removed and a new layer~~

~~of fertile topsoil be applied.~~

~~SITE ACCESSIBILTY, UTILITY AVAILABILTY a MAJOR THOROUGHFARES~~

~~Necessary public utilities such as gas, sev;ers, electricity and water~~

~~are conveniently available. Utility easments run along the north side, or~~

~~at the rear of the propose site, from east to west. Because of the site's~~

~~location, auto accessibility is limited but can be achieved either from~~

~~the south (Interstate 10) or from the east (caper street). Auto access is~~

~~a major factor in the accessibility disign.~~

~~Major Thoroughfares~~

~~The arterial system of the Southeast Planning Area forms a grid~~

~~pattern. Major east/west arterials are: Montana avenue, Edgemere Boulevard,~~

~~Montwood drive and Interstate Highway 10. Major north/south arterials are:~~

~~Airway Boulevard, Hawkins Boulevard, McRae Boulevard, Yarbrough Drive and~~

~~Lee Trevino Drive. This pattem has encouraged úniforra, low-density -~~

~~development, with concentrations of apartments and commercial services~~

~~at major intersections and along the freeway.~~

~~97 Ui o 9UJ co o: o < LU~~

~~ê a. cn O o o i < UJ~~

~~o îS a~ t- (n UJ X o 1- < o -3 w~~

~~O JAVvTES (SCAT C]TY B I? 1 EL PASO. TEXAS sc i"= 3oo' MAJOR THOROUGHFARES~~

~~-Z* síiÍFiS'íí -^ií^. -.^^í"':- i "ji_íi^_—*:~~

~~%^ L E G E ND EXISTING 90' R-O-W SITE LOCATION EXISTING 120' R-O-W~~

~~PROPOSED 70' R-O-W —— PROPOSED 90' R-O-W •••• PROPOSED 120' R-O-W 0 PROPOSED INTERCHANGE ^ PROPOSED BRDGE~~

~~Source: MPQ 12-13-77~~

~~VPD- VEHICLES PER DA Y ( 1 9 7 6 - 1 9 7 7 FtGURES)~~

~~DEPARTMENT OF PLANNING, RESEARCH & DEVELOPMENT EL PASO, TEXAS FEBRUARY, 1978 • SCALE r^SOOO' COMMUNITY FACII IT|F.q~~

~~The number, size and location of existing community facilities in the~~

~~Southeast Planning area have been evaluated in order to provide a basis~~

~~for assessing future needs. This information is shovm on the Community~~

~~Facilities Map on page.~~

~~Community facilities are those facilities which serve the general~~

~~public. They may be under public ownership (schools, fire stations and~~

~~parks) or private ownership (shopping areas and hospitals). In order to~~

~~function well, there is a minimum and a maximun n'umber of persons which~~

~~a school, shopping center or parksserves, In addition, the facility~~

~~must be properly located. High Schools raust be located on at least one~~

~~raajor arterial to insure adequate access. ELementary schools should be~~

~~located on local streets to avoid children crossing arterials on their~~

~~way to school. Certain facilities are corapatible and supportive of one~~

~~another(schools and parks, for example); others are basically incompatible~~

~~(such as fire stations and hospitals).~~

~~102 ptll! mm.I niBE> ,'r-»,^ -~~

~~COMMUNITY FACILITIES~~

~~feunf-' 1* NORTH US62&A80 m~~

~~— IZZ _., '~~

L E G E N D FIRE STATIONS HOSPITALS • COMMERCIAL ( Shopping Centers) t PARKS & RECREATION 1 Ponder (C) 8 Tyrone (N) 2 Eastwood (C) 9 Pico Norte (N) 3 MacArthur(N) 10 Travis White (N) 4 Cielo Vista (N) 11 Palm Grove m 5 Scotsdale (N) 12 Pebble Hills (N) 6 Cork (N) 13 Mosswood (N) 7 Suffolk (N) (P) PROPOSED SITES SCHOOLS 1 Burges High 7 Eastwood Knolls Elem. 13 Hanks Jr- SrHigh* 2 Bonham Elem. 8 Eastwood Heights Elem. 14 East Glen Elem. * 3 MacArthur Elem./Jr. High 9 East Pôint Elem. 15 Proposed Jr High 4 CieloVista Elem. 10 Eastwood Jr High is Proposed High Sch. 5 Scotsdale Elem. 11 Edgemere Elem. n • i» Proposed Elem. Sch. 6 Eastwood High 12 Vista Hills Elem.

~~(R)-REGIONAL (C).COMMUNITY NEIGHBORHOOD * UNDER CONSTRUCTION~~

~~DEPARTMENT OF PLANNING, RESEARCH & DEVELOPMENT EL PASO. TEXAS FEBRUARY, 1978 SCALE 1 " = 3000' THE LAND - TOPOGRAPHY~~

~~The natural features of an area are the starting points for developing~~

~~the land. Soil types, slope and drainage are all oonsiderations which affect~~

~~possible uses of the land and the cost of developing it.~~

~~The Southeast Planning Area is divided into two distinct natural~~

~~areas: the Hueco Bolson and the Escarpment of the Rio Grande Valley. The~~

~~Bolson is a relatively flat basin between the Franklin Moxintains on the~~

~~west and the Hueco Mountains of the. east. The Escarpment is a steep, hilly~~

~~area which foms the boundary of the Rio Grande Valley.~~

~~Construction in the basin must take into consideration certain diffi-~~

~~culties. Surface soil is very sandy, which makes it subject to blowing dust.~~

~~There is a layer of hard caliche about 20 to 40 inches beneath the surface~~

~~which creates problems for contruction. Low points in the basin do not into~~

~~the Rio Grande, therefore ponding areas are needed to catch the runoff~~

~~during heavy rains.~~

~~The Escarpraent area generally has rauchmor e favorable soil conditions~~

~~than the Bolson for development. However, there are areas of the Escarpment~~

~~with steep slopes, and other areas with flooding problems. Urban development~~

~~should be avoided in these areas, which coraprise only a sraall portion of~~

~~the Escarpraent,~~

104 In general, the natural features of the Southeast Planning Area offer few obstacles to urban growth. The flat terrain of the Bolson is highly desirable for developraent. líhile the Escarpment is not level, it does have highly favorable soils and the slopes are not too steep even for industrial development. In addtion, the Escarpment line and other points below it offer beautiful views of the Lower Valley, downtown

~~El Paso and much of Ciudad Juarez.~~

~~105 EL PASO. TEXAS sc i"= OO'~~

~~'^^'^'^. -~~

*-• V

~~NATURAL FEATURES •v^^ "^^*-^^^ ^ Si~~

~~'V . •"~~

~~JÊH ^ l^ j4» ^~~

~~l^ias^'vA CITY LIM^TS NORTH~~

~~L E G E N D~~

~~"»~"fc.,''^í,„i ESCARPMENT LINE pl| HUECO BOLSON NATURAL ^•^ REGION~~

~~RIO GRANDE VALLEY SITE LOCATIQN ESCARPMENT/TERRACE DRAINAGE PONDING AREAS 100 YEAR FLOOD PRONE AREAS~~

~~"..~~

~~''TSfo\?ÍA ''pp''^^^ RESEARCH & DEVELOPMENT tL PASO. TEXAS FEBRUARY, 1978 SCALE 1 "=3000' EXISTING LAND USE~~

The following table and accompanying map show the axistirig land uses in the Southeast Planning Area. The table shows that the Planning Area has a higher percentage of residential and commercial uses than the City-wide average, but a smaller amount of industrial, public and quasi-public, and park uses. The comparison of data between the Planning Area and the City highlights the basically residential character of the Planning Area and it also emphasizes that commercial development in the Planning Area serves a City-wide clientele.

~~TABLE 1~~

~~Existing Land Use~~

~~Land Use acres /oOf $ of Citywide Developed Total $ of Land Land Developed Acres~~

Low Density Residential 2,/+Ô0 42.1 23.2 30.6 Medium Density Residentiaall 272 4.6 2.5 3.6 Commercial 465 7.9 4.3 5.1 Industrial 267 4.5 2.5 7.1 Public and Quasi-public 248 4.2 2.3 19.9 S.l Parks and Open Space 412 7.0 3.9 2.8 Drainage and ponding Area:ass 101 1.8 .9 22.8 Streets and-Public R-O-Wf 1,642 27.9 15.3 100.0 100.0 Total 5,887 54.9

~~109 EXISTING LAND USE L E G E N D [~] RESIDENTIAL Low Density RESIDENTIAL Medium Density COMMERCIAL INDUSTRIAL PUBLIC & QUASI - PUBLIC OPEN SPACE & RECREATION PONDING AREAS I I VACANT / UNDEVELOPED~~

~~DEPARTMENT OF PLANNING, RESEARCH & DEVELOPMENT EL PASO, TEXAS FEBRUARY, 1978 SCALE 1 " = 3000' PHASING a IMPLEMFMTATinivi~~

The usefulness of the Southeast Land Use Plan as a guide to future developraent will depend upon day-to-day decisions made within the public and private sectors. Reference should be made to the Plan in zoning and subdivision cases... not so much to determine what the Plan calls for at a particular location, but rather what the general intent of the Plan is, and to decide if the proposal will advance that intent. It is recognized that circumstances change over tirae and therefore details of the Plan must change as well. The real value of the Plan resides in the overall land use proportions it reflects, and the relationships between land uses and the population projections.

Table 10 shov;s the population and acreage range projected to occur frora I98O to the year 2000. Due to a rapid grov/th rate, it is projected the Southeast Planning Area will be fully developed by the year 2000. Substantially all of the land now vacant vjest of Lee Trevino Drive víill be developed by 1985 (land along the southside of Montana Drive may be an exception). By the year 2000, there will also be substantial development to the east of the Planning area in the nevrly annexed area.

Development generally occurs in well-define phases. Single faraily homes are usually marketed first, vdth coramercial development following after there is a substantial population of single faraily or apartraent residents. After residential development has begun, it often takes 2-4 years to provide the necessary public facilities. Development, therefore, is a joint effort between the private and public sector, and is impleraented or achieved over a long period of time.

The first step toward implementation of the Land Use Plan for the Southeast Planning Area is its formal adoption by the City Plan ConiT.is- sion and the City Council. These two public bodies must not only be av:are of the plan but committed to using it as a guide for developraent in the Planning Area. Their policy decisions on the subdividing of land, zoning, and capital iraproveraents vri.ll go a long way tov/ard shaping the physical environment in the Planning Area. Other public agencies such as the utility companies, the independent school districts, the Public Service Board and the Airport Board can also use the Plan as a .guide v;hen naJ

~~TABLE 10 Population and Acreage Projections'^~~

~~Population Acreage Low High Loví High~~

1980 60,000 74,000 6,360 7,844 1985 74,000 86,000 7,844 9,116 1990 86,000 100,000 9,116 10,600 1995 100,000 115,000 10,600 12,190 2000 115,000 125,000 12,190 13,250 *Included population and development east of George Dieter Drive in the newly-annexed area.

~~••l^ «- .JIK^ I Ljiij. y%akg^%P^~~

~~PROPOSED LAND USE - YEAR 2000~~

~~-. ••':*» , '^•mMS', cnv um^'^s US 62 & ^»0 NORTH~~

~~R!îl F H'î L%~~

~~AREA ANNEXED IN DECEMBER. 1977~~

~~»0 L. E G E N D~~

~~EXlSTlNG PBOPOSED Si 1 RESIDENTIAL Low Density RESIDENTIAL Medium Density COMMERCIAL SITE LOCATION INDUSTRIAL PUBLIC & QUASI - PUBLIC OPEN SPACE & RECREATION PONDING AREAS~~

~~DEPARTMENT OF PLANNING, RESEARCH & DEVELOPMENT EL PASO, TEXAS FEBRUARY, 1978 SCALE r' = 3000' CLIMATE~~

~~Teraperature; One of the raost attractive features of EL Paso is its mild climate. Although many people not familiar with the area think of EL~~

Paso, located in a desert region, as being essentially hot in sumraer and warm in víinter, local teraperatures corapare favorably with other areas of the U.S. average annual temperature is 63.4 F. Average dails winter temperature is 45.5 F, váth average lovj night-time temperature of 31.8 F and average high day-time temperature of 59.1 F. Minimum low temperature recorded is -8 F.

AVERAGE TEt^PERATURS ( F) lEAR JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV 1950 49.2 53.4 58.0 65.9 72.1 82.5 79.6 80.6 74.4 70.7 54.0 1960 42.4 46.3 59.7 66.3 73.7 85.0 81.9 82.5 75.6 63.5 52.9 1970 46.9 52.3 55.6 63.5 72.2 79.7 82.8 81.4 74.2 59.5 51.9 1980 46.8 50.6 54.1 60.6 70.5 86.3 87.2 82.4 75.6 60.3 49.2 Mean 44.7 49.3 55.6 63.7 72.2 80.8 82.0 80.3 74.8 64.6 52.4

~~YEAR DEC ANWUAL 1950 49.5 65.8 1960 38.9 64.0 1970 48.0 64.0 1980 48.5 64.3 Mean 45.2 63.8~~

~~114~~

~~PREVALiNG WINDS~~

~~H EL PASO Ei. PASO 1 l~~

~~JANUARY MARCH F/. PA50 u ;t^ í ^\ JUAeEZ~~

~~APRIL MAY JUNE~~

~~S S-PASO \t^~~

~~T\ JUAnez~~

~~JULY AUGUST SEPTEMBER~~

~~EL fiíN< 30 ei. PA50 eiPA'bú 1 ,~~

~~jUAefz y\ Jí]Ae.B2. w. NOVEMBER DECEMBER OCTOBER 116 ZONING CODES~~

Zoning: The site zoning is under G2, which designates the Comraercial district. The purpose of this district is to provide sufficient space in appropriate locations for retail and personal services and some coraraercial recreational uses, serving several netghborcholds in the

~~City. (sec.25-33.1 city codes). Below are listed the zoning codes for the site, of the city of EL Paso. Godes are as follows:~~

Access. Each site shall have a miniraum street frontage of one hundred fifty (150) feet along a street approved as being adequate for purposes of access to the proposed project, except that lots abutting cul-ae- sacs or street turning heels shall have a minimum avera^e lot width of one hundred fifty (15O) feet.

~~Performance. No noise, fumes, dust or odor may be emitted that would be evident or noticeable at site property lines.~~

~~25-31-10 Off-street parking and loading standars. Off-street parking~~

~~and loading design standards and space requirements for particular uses are contained in sections 25-60 and 25-61.~~

~~Sec. 25-32. C-1 Commercial District~~

25-32.1 Purpose of the District. The purpose of this district is to provide primarily for retail shopping and personal service uses, to be developed either as a unit or in individual oarcels, to serve the needs of a residential neighborhood.

~~117 25-32.2 Permitted uses. A building or land shall be uses only for the follovång purposes:~~

~~25-32.7 General height standards.~~

~~All buildings-Maximum height of two and one-half (2 I/2) stories and floor area ratio of 1.0.~~

Buildinjs may exceed thirty-five (35) feet in hei--;ht where an ac.citional setback of one foot is provided from all required adjacent yard lines for each one foot or height in exess of tliirty-five (35) feet.

~~The floor area ratio may be increased in accordance vdth procedures of section 25-64.~~

~~Use or use category Off-Street Parking Spaces Required~~

~~Hospital (for outpatient serv- Two (2) per patient beds.~~

~~ices, see medical cffice~~

~~or clinic)~~

~~m for public utilities, and similar uses may be permitted, as a special~~

~~exception, in the districts, where so specified.~~

~~Sec. 25-64. Supplementary height, area and density requirements.~~

~~25-64.1 Height regulations. Heretofore established height regulations~~

~~are modifies as follows:~~

~~(1) No new biiilding may be erected or existing building increased in~~

~~height in such a manner as to shade a solar heating or power facility.~~

~~(see section 25-65).~~

~~(2) Public, semipublic service buildings, hospitals, institutions, or~~

~~schools when permitted in a district, may be erected to a height not~~

~~exceding one hundred (lOO) feet, and curches and temples raay be~~

~~erected to a height not exceeding seventy-five (75) feet if the building~~

~~is set back frora each yard line at least one foot for each foot of~~

~~additionál buildihg height above the height lirait othervn.se provided~~

~~in the district in which the building is built.~~

~~(3)Church spires, belfries, raonuments,tanks , water and fire towers, wind-~~

~~mills, stage towers or scencery lofts, cooling towers, ornamental towers,~~

~~and spires, chimneys, elevator bulkheads, stacks, conveyors and~~

~~flagpoles may exceed height limits upon special authorization by the building official.~~

~~119 Of El Paso~~

~~25-32.4 Permitted signs. Subject to the general sign regulations in section~~

~~25-62, the follovdng accessory signs are perraitted:~~

~~(1) Advertising signs.~~

~~(2) Business signs.~~

~~(3) Church identification signs or bulletin boards not to exceed forty (40)~~

~~square feet in area,~~

25-32,5 Uses permitted by special perrait, The following uses may be perraitted by special permit if approved by the city council, våth or v^dthout conditions, following report by the city plan commissions, in accordance vd-th the procedurss, gioides and standards of section 25-83:

~~(1) Public or governmental buildings and uses.~~

~~Square Feet of Aggregate Reqiiired Number~~

~~Gross Floor Area of Berths~~

~~Over 160,000 up to and including 240,000 4~~

~~Over 240,000 up to and including 320,000 5~~

~~Over 320,000 up to and including 400,000 6~~

~~Over 400,000 up to and including 490,000 7~~

~~í'or each additional 90,000 over 490,000 1 additional~~

~~(2) Any auditorium, convention hall, exhibition hall, hotel, multifamily~~

~~dwelling, office bviilding, restaurant, sports arena, hospital or~~

~~sanitarium. which has an aggregate gross floor area of one hundred~~

~~thousand (100,000) square feet or more arranged, intended, or designed 120 for such use shall be provided with off-street loading berths in accordance with the following table:~~

~~Square Feet of Aggregate Gross Floor Area Required Nuraber of Berths~~

~~100,000 up to and including 150,000 1~~

~~Over 150,000 up to and including 400,000 2~~

~~Over 400,000 up to and including 660,000 3~~

~~Over 660,000 up to and including 970,000 4~~

~~Over 970,000 up to and including 1,300,000 5~~

~~Over 1,300,000 up to and including 1,630,000 6~~

~~Over 1,630,000 up to and including 1,960,000 7~~

~~Over 1,960,000 up to and including 2,300,000 8~~

~~For each additional 350,000 over 2,300,000 1 additional~~

~~25-65,1 Protection of Views.~~

~~(1) In all zoning districts, except the C-5 District, x^rhere forty (40)~~

~~per cent or more of a frontage is occupied by buildings, no nev/ or~~

~~enlarged building may be erected to a height greater than the highest~~

~~elevation of an existing building on any lot vjithin one hundred (lOO)~~

~~feet of the lot to be built upon; provided that tiiis shall not prevent~~

~~the construction of a one-story building and proviaed further that the~~

~~121 board of adjustment upon appeal may permit a higher building víhere this does not interfere with a view from any existing building.~~

~~122~~

~~SFACE SUMMARY~~

~~Total net buildin^ Area.~~

* Administration 7,149 Sq. Ft

* Nursin- Unit 26,649 Sq.Ft.

* Intensive Care Unit 2,371 Sq.Ft.

* Surgical Suit 3,421 .3ci. Ft.

* Elnergency Department 1»545 Sq.Ft. * Auiciliar;^^ Suppcrt 3,473 Sq.Ft.

* Pharmacy Department 1,120 Sq.Ft. * Mor^ue Room lfl37 Sq.Ft. * Food Service & Distribution L.,560 Sq.Ft.

* Laundry Services 4,345 Sq.Ft. * anployee's Facilities 1,322 Sq.Ft. * Storage Facilities 5,230 Sa.Ft. * Service Area ^»^56 Sc.Ft. Total 69,378 Sq.Ft.

~~Total Gross Area~~

~~Total Net Area ^ ^^^^1 Gross Area Net to gross ratio~~

~~^2i37â ^ 121,715.79 Sq.Ft. .57~~

~~124 ADMINISTRATIOry | SPACE OCCUR AREA SQ.FT DETERMINED BY PUBLIC AREAS~~

001 Entrance and Planing Guide. Graning looby Area 48 675 002 Public entrance varies 100 Planing Guide. Graning 003 Retiring Faci- 13 200 Lindheim lities 004 Gift shop & 15 320 Planning Guide, Graning snack Area 005 Play area 10 500 Planning Guide. Granin^: 006 Public restroom 3 110 Hancock-time Saver Public restroom 3 110 Hancock-time Saver Public Tele.Boo h 30 Vargas ADMITTING DEPT. 007 Adm.Desk Area 2 132 Planning Guide. Graning 008 Adm. Office 1 200 Planning Guide, Graning & Gubicles 3 120 Planning Guide. Graning 009 Work Area 1 215 Seidel 010 Machine Room 3 140 Planning Guide. Graning 011 Wheelchair Alo- 25 Planning Guide. Graning we 012 Coatroom 42 Planning Guide. Granin'- 013 Toilet 1 30 Hancock-Time Saver

FINANCIAL AREA 014 Sec. Office 4 132 Planning Guide. Graning 015 Manager's Officf 4 117 Planning Guide, Graning 016 Inforraation 3 160 Planning Guide. Graning 017 Cashier Area 1 144 Siedel OIS Interview officí 3 108 Planning Guide, Graning 019 Clerical work 4 305 Planning Guide. Graning Area 020 Machine Room 1 300 Planning Guide. Graning

NURSING SERVICE DSPT. 021 Secretarial & 5 287 Planning Guide. Graning Clerical Work 022 Director's Offic 3 7 169 H.F.W. 023 Assistant Dire£ 7 192 H.F.:Í. tor 024 Conference 8 252 Planning Guide. Graning 025 Toilet & Locker 3 108 Planning Guide. Graning 026 Storage Room 40 Planning Guide. G-ranin:;

~~EXEGUTIVE UNIT 327 SecreiarÍÊlÅ 5 216 Planning Guide. Graning Glerical 328 Administratorc 5 208 Planning Guide. Graning Office~~

~~TOTAL NET AREA 125 CONT. SPACE OCCUR AREA SQ.FT DETERMINED BY~~

029 Assistant Offic 4 156 Planning Guide, Graning 030 Conference Rm. 38 740 Planning Guide, Graning 031 Coatroom 54 Planning Guide. Graning 032 Storage Room 126 Planning Guide, Graning 033 Library 10 254 Vargas 034 MicroRoom 60 Planning Guide. Graning 035 Toilets (men) 2 36 Hancock-time Saver (women) 2 36 Hancock-time Saver

~~TOTAL NET AREA 7,149 126 NURSING DEPT NURSING DEPT SPACE OCCUR AREA SQ.FT DETERMINED BY~~

036 Team Center 12 1,104 Pediatric facilities Ross 037 Medication Rm. 294 Planning and Dêsign.Donal d 038 Office Space 2 600 Planning and Desirn.Donal d 039 Clean utility 1 600 Planning and Design. Donald 040 Nourishment 2 300 Planning and desi:^n. Donald 041 Conference Rm, 15 600 Planning and Design, Donald 042 Waiting Rm 14 600 Planning and Design, Donald Planning and Design. Donald 043 Playroora Varies 1,200 OUU 1-bed, roora(24) 24 (closet.private toilets) Hew-Dodge Corp. 045 2-bed room (38) 76 14,400 300 Heví-Dodge Corp. 046 Treatment/exaram: 4 nator Varies 1,800 Hew-Dodge Corp, 047 Solariums 576 Yanel 048 Isolation Rm 4 NURSERY UNIT Hew-Dodge Corp. 049 Nursery (14) 14 560 Nurses station 4 240 Seidel Work/treatment 4 320 Hew-Dodge Corp. Forraula Room 100 Hew-Dodge Gorp, Hancock-time Saver Nurse's toilet 25 Planning facilities.-Ross 050 Nurse's Lockers 6 750 Hancock-Time Saver 051 Public Toilets 3 150 Planning and Desi,gn, Donald 052 Soiled Utility Varies 360 240 Planning and Design. Donald 053 Doctors' Consul 3 Planning and Design. Donald 054 Equipraent Stora^ s 3 300 ad 055 Strecher/víheelcl: Estimated storage Varies 360 Planning and Design. Donald 056 House staff Of. 2 240 Planning and design. Donald 057 Linen Storage Varies 480 Estimate 058 Janitors' close-t None 150

TOTAL NET AREA 26,649 127 IN ENSIVE CARE UN T INTENSIVE CARE UNIT SPACE OCCUR AREA SQ.FT DETERMINED BY INTENSIVE CARE UNIT 59 Nursing station 6 160 Planning & Design. Dasler 60 Scrub & Gown 2 50 61 Medication Prep, 1 50 62 Physcians Dicta- tion 3 60 63 Conference Rm, 1 250 64 Clean Supply 2 130 65 Soiled Supply 2 80 66 Equipment Storag 2 120 67 Treatment Rm, 4 130 68 Wating/quiet Rm 14 280 69 Patient Toilet 1 25 70 6-bed Room 6 720 71 Isolation Room(2 2 316

~~TOTAL NET AREA 2,371 128 ûUttU-lUAL SUITE SURGICAL SUITE SPACE OCCUR AREA SQ.FT DETERMINED BY~~

SURGICAL SUITE 72 Mayor Operating 576 Hew-Dodge Corp. Room (6) Minor ooerating 265 Hew-Dodge Corp. Room (4) 73 Recovery Room 5 880 Planning Surgical -Smith 74 Scrub-Area 4 185 II II II II II II 75 Waiting Room 12 200 II II II II II II 76 Supervisor's Office 1 100 II II II II II II 77 Clean work & Sto 1 30 II II II II II II 78 Dackroora 1 100 II II II II II 79 Anesthesist's Room 1 150 II 11 II II II 80 Substerilizing Rn 2 245 II II ti II II 81 Doctor's Lounge

TOTAL NET AREA -5 I OT 129 MJ RGENCY DEPT, EMERGENCY DEPT. SPACE OCCUR AREA SQ.FT DETERMINED BY MERGEMCY DNTT 83 Writing Arealtor 10 200 Seidel 84 Surgery Room 3 280 Hew-Dodge Corp, 85 Exam/Treatment 3 250 II II II II II 86 Nurses station 3 100 11 II II II II 87 Observation 2 205 II II II II II Usual Area Ambulance Entran|e 150 Seidel Office 80 Hew-Dodge Corp. Storage/supply 45 11 II II II II Strecher & Wheél chair 50 11 II ti II II closet clean-up room 80 Hew-Dodge Corp, utility room 45 II II II II soiled linen Rm 25 Seidel Janitor's closet 15 Estimated toilet 20 Hancock-Time Saver

TOTAL NETAREA 1,545 130 AUXILIARY SUPPORT FACILITIES AUXILIARY SUPPORT FACILITIES SPACE OCCUR AREA SQ.FT DETERMINED BY 88 Laboratory 8 745 Vargas Radiology Suite 89 Radiolo.gy & Flurc scupy Rm 300 Seidel 90 Office 100 II II II 91 Film processing jn 1 200 Vargas other areas Dr. viewing Rm 40 Vargas Control Rm 70 Vargas Ligh Rm 80 ti II II Dressing Rm 16 II 11 II Strimer Holding 50 II II II X-Ray machine 50 II II II Storage Rra 40 Seidel Toilet.' 40 (1731) Hancock-time Saver ^HYSICAL TH RAPY SUI 'E 92 Examination Rm 100 Vargas ?3 Hydrotherapy Rm 200 Vargas ?4 Patient's Locker 300 Vargas ?5 Therapist's offic 100 Vargas usual area waiting Rm 125 Vargas exercise Rm 430 Seidel Linen Storage 30 Vargas Patient's Shower 150 Estimate Toilet 30 Hancock-Time Saver Strích; & wheelchfir vlcove 70 (1535) Seidel '6 Ekg, Bnr & Speciprlen Rm 3 207 Hew-Dodge Corp.

~~TOTAL NET AREA 3,473 131 PHARMACY DEPT. PHARMACY DEPT SPACE OCCUR AREA SQ.FT DETERMINED BY~~

~~PHARMACY 97 Compounding & dispeasing Lab 495 Hew-Dodge Gorp. Solution Lab, 200 II II II II II Active store Rra 200 II II II II II Man, Laboratory 120 II II II II II OFFICE 105 II II II II II~~

~~TOTAL NET AREA 1,120 Sq.Ft. 132 MORGUE ROOM MORGUE ROOM SPACE OCCUR AREA SQ.FT DETERMINED BY~~

MORGUE 98 Autopsy Room 410 Yanez Refrigeration Facilities 56 II II laboratory Rm, 2 188 II II Office 1 100 II II II Administrative 150 II II II Record Rm 113 II II II Staff Shower Rm 95 II II II Staff Toilet 20 (1137) Hancock-Time Saver

~~TOTAL NET AREA 1,137 Sq, Pt. 133 FOOD SiRVICES AND FOOD SITRIBUTION FOOD- SERVICES AND DISTRIBUTION SPACE OCCUR AREA SQ.FT DETERMINED BY~~

FOOD PREPARATION CE ITm 99 Kitchen & Bakery 2,400 Hew Dodge Gorp LOO Forraula Rm 255 II 11 II II II I • Walk-in refrigeration 60 II II II II II Dairy refrigeration 35 II II II II II vegtables refrigeration 95 (2845) II II II II II Supporting Faciliti Recelving Area 2 50 Heví-Dodge Corp, Dishwashing Area 1 255 II II II II II Potwashing Area 1 200 Vargas Cart Clearu.ng 200 Vargas Day storajge 125 Vargas Garbage Coriectioi 100 Hew-Dodge Gorp. Janitor's Closet 40 (970) II II II II II Miscellaneous 101 Dining Room 120 580 Heví-Dodge Corp. dietician's offj 1 165 (745) II II II II II

~~TOTAL NET AREA 4,560 Sq.Ft. 134 LAUNDRY SmVICE LAUNDRY SERV CE SPACE OCCUR AREA SQ.FT DETERMINED BY~~

102 Laundry Central Linen 4m 1 500 Vargas Soiled linen Rif 1 260 Heví-Dodge Gorp. Clean linen & /^,00 Vargas Sewing Rm 200 Laundry Proce- ssing 1,010 Estimate Linen Cart Sto- rage 200 Vargas office 100 Estimate Lavâtories 100 Estimate Jam, closet 30 (2800) Vargas Sterilizing Area 103 Sterilizing Area 1 145 Yanez Non, Sterilizirfe Area 400 Yanez Storage 400 Seidel Washing & Prep. 600 (1545) Yanez

TOTAL NET AREA 4,345 So_.Ft, 135 MPLOYEE FAGILITIJS EMPLOYEE FACIUTIES SPACE OCCUR AREA SQ.FT DETERMINED BY Male Help Lockers Room Lockers 450 Hancock-Time Saver Showers/Toilets 136 II II II II Female help locker Roora Lockers 600 II II II II II II Showers 36 11 11 II II II II Toilets 100 II II II II tl II

TOTAL NETAREA 1^322 Sq. ?t. 136 STORAGE FAGILITIIS STORAGE FACILITIES SPACE OCCUR AREA SQ.FT DETERMINED BY CENTRAL STORAGE ARE Receiving & Unerati: 200 Estimate General storage 2,000 Estimate Clealí's office 120 Estimate Bulk food (separate 400 Estimate Linen (separate) 200 Sstimate Volatile liquid 80 Estimate Volatile Gas 80 Seidel Equipment 1,800 Seidel Repair Shop 200 Seidel Distribution Area 150 Seidel

TOTAL NET AREA 5,230 on.Ft. 137 SERVICE AREA SERVICE AREA SPACE OCCUR AREA SQ.FT DETERMINED BY B3UIPMEfn? AREA Boilcr Rooi.i 1,500 Vargas Mechancal Room 2,341 Yanez ELectrical Room 1,400 Yanez Gear Closet 35 Hevj-Dodgc Corp Incinerator 100 Vargas MAINTSNANCE SHOPS Garpeh'ter Shop 290 Hex-í-Dodge Gorp Electrical Shop 345 II II II II II Refinish Shop 165 ti II II II II General maintenance 180 Estimate Storage roora 600 Vargas

~~MISCELLANEOUS Yard storage 100(7,056) Vargas Parking Doctors 45 oar 5,985 EL Paso Gode Staff 600 car 13,300 EI Paso Code Visitors 236 car 31,388 II II II II Ambulance 4 550 II II 11 II 11~~

~~TOTAL NETAREA 7,056 Sq, (cxclucin-; Darlcin •;) 138 SYSTEMS PERFORMANCE CRITERIA~~

~~-' 139 NOTE:~~

~~The folloxclng data applies to the sections describe as standard under~~

~~the tile of Architectural Gonsiderations:~~

~~Lighting: Non-glare, non-heat producing~~

~~It is essential that the electrical supply for hospitals be adequate and~~

~~dependable. Blood banks, refrigerators, respirators, surgical lighting~~

~~as îíell as other vital equipment, cannot be ;íithout electrical pov/er for~~

~~even short periods.~~

~~The demand on electrical energy is usually higher than for nost building~~

~~types, For this reason, the quality of materials and equipment must be~~

~~high and future maintenance must be considered during the course of the~~

~~design.~~

~~ELectrical:~~

~~Convenience outlets should be installed in all places where plug-in service~~

~~is likely to be required. Duplex receptacles are generally preferrec, except~~

~~for hea-vy duty service or other specific requirements. Grounding type~~

~~receptacles should be installed in kitchens, oantries, utility rooms, laund-riesf laboratories, boiler rooms, and other work areas likely to have~~

~~wet floors.~~

~~l4o HVAC:~~

~~The general criteria for a corafdtable atmospheric en-vironment for~~

~~healthy people are satisfactory for hospital patients, except that more~~

~~attention must be given to the quietness of the system, the air distribu~~

~~tion, relative humidity (RH), and the degree of air filtration and~~

~~freedom from bacteria. Specific design recoraraendations for the principal~~

~~areas of a hospital are as follows:~~

~~SUMMER WINTER 0 AREA F,D.B. foRB. F,D.B. fiRH~~

~~Operating suite 68-85 55 68-85 55~~

~~Recovery suite 75-80 50-55 75-80 50-55~~

~~Patients' areas 74-78 40-50 72 40-50~~

~~Peripheral vascular 72-76 40 72-76 40~~

~~Incubator and nursery 85-90 35-45 85-90 35-45~~

~~All other air conditioned~~

~~Areas 74-78 40-50 72 40-50~~

~~D.B.= Dry Bulb Teraperature RH= Relative Humidity~~

~~Exercise, physical therapy, X-ray, and locker rooras and bathrooras should~~

~~be maintained at 75° minimura during the heating season. Patients' baths,~~

~~swimraing pools, sitz baths, etc, should be kept at 80°F. Many of the~~

~~141 service areas such as kitchens, storage and repair spaces, etc, may be kept at 60 F in the vd.nter.~~

Patients' bedrooms: The metabolic rate of bed patients is reduced, ma- king them more sensitive to drafts. Hence air distribution should be uniforra and air velocity at patients' level no raore than 30 to 40 fpm. The air-distribution system must be designed for very quiet operation (NC-30 curve). The exhaust air from rooras of noninfectious patients may be transferred to corridors, toilets, and nurses' working areas. A rainiraum of 25 per cent outside air is desirable. General patients' quarters and associated nurses' working areas should have their own air-distribution system because they require 24-hr operation.

~~Areas for patients ha'ving infectious diseases or allergies must have~~

100 per cent outside air, and each room must have a separate exhaust air connection so that none of the air goes into the corridor. If Administrative area is treated in rauch the sarae raannera s an office-building area since its operation is usally 10 to 12 h per day, it can be combined with the out patient clinic area into one air-distribution system, if it is architecturally or raechqnicallyfeasible .

Operating rooms require a våder range of temperature and hiomidity control that most other areas. The temperature range is to provide optiraum comfort conditions for bath medical staff and patients and is controlled by the staff. The high level of RH is to rainiraize the possibility of electric

~~142 static discharges, which raay cause explosions, Also certain types of operations may require a high RH,^^~~

~~COMMUNICATIONS~~

~~Interconnecting telephones should be provided for all departments, heads,~~

~~assistants, operation nurses' stations, offices, housekeeper, maintenance~~

~~supervisor, doctors' rooras, record rooras and diet kitchens. These may be~~

connected on a dial systera which vd.ll perrait interior coramunication through the hospital board svd.tch without the assistance of an operator. At all private and semi-private beds, telephone jacks should be installed so that

~~a telephone can be plugged in at any time, vd.th a minimum rental charge to~~

~~the hospital. This arrangement is efficient and satisfactory,~~

~~Conduit should be pro"vided for all telephone wiring, Installation and~~

~~connection of vdring is usually done by the telephone company. Provision~~

~~should be made for public telephones at convenient locations for -visitors 16 and others requiring the use of pay stations.~~

~~WALLS:~~

~~Textured wall coverings add warmth and interest to surroundings. Murals~~

and panoramic scenes in patient rooms help give an open look. Repeated washings and rough treatment from young patients necessitate use of very durable material. Vinyl wall coverings especially designed for hospital use meet requirements for durability very well. Although initial cost is slightly greater than that of some other wall coverings, long-wearing aspects of

~~143 vinyl make it economical by comparison to the redecorating cycle of less~~

~~durable materials. 17~~

~~FLOORS:~~

~~High-density, short-pile nylon or acrylic carpeting recoramended for~~

~~all but a few areas (janitor station, equipment storage, soiled utility and~~

~~bathrooms), This type of carpeting not only helps dispel the "cold institu -~~

~~tional look" but offers very effective acoustical .properties, is more easily~~

~~and economically raaintained, inhibits bacterial and fungal grovrt-h, and redu-~~

~~ces injuries due to falls. After 2 years' use in an example hospital, in has~~

~~shovm practically no wear, even in hi.gh traffic areas. It resists staining~~

~~from urine, oil, grease, food substances, paint, floor wax and organic~~

~~fuids. Non-professional personnel clean it in less time that is needed to~~

~~clean hard surface floors. Carpeting can be installed directly over most~~

~~existing flooring.~~

~~For non carpeted area; cleanable, hea-vy traffic resistant raaterials,~~

~~easily washed, resistant to anticipated traffic should be used.~~

~~CEILING:~~

~~Light reflecting sound absorbing systera, not supporting bacterial~~

~~growth, with capability of incorporating HVAC ducts. arilles and lighting~~

~~fixtures should be used.~~

~~144 Each operating should be provided xd.th not less than three receptacles of~~

~~the lock-in type suitable for interchangeable type plugs as described in~~

~~NFPA N0.56A of The National Fire Protection Association.~~

~~Patients' bedrooms should have at least three duplex outlets for sin^le-~~

~~patient rooras, \~~

~~one patient should have a sirailar arrangeraent of outlets. Preferable, there~~

~~íhould be two duplex outlets at the head of each bed, or at least three out-~~

~~lets on the head virall for each two beds side-by-side.~~

~~Each bed in recovery rooras and in intensive care niu'sing rooms should have~~

~~two duplex receptacles near the head 01 the bed, Intensive care nursing~~

~~rooras should, in addition, have pro"vision for mobile X-ray,~~

~~Carridors should have grounding type outlets every 50 ft for use of cleaning~~

~~machines, Unless capacitive discharge or battery-powered mobile x-ray is~~

~~used, receptables for this purpose should be spaced 40 ft apart in carridors~~

~~of patient areas,~~

~~ACOUSTICAL:~~

~~Noise transmission to patient and administrative work areas should be kept~~

~~to a rainimura.~~

~~145 DOORS AND WINDOWS~~

(1) Rooms containing bathtubs, sitz baths, showers and water closets , subject to occupancy by patients, shall be equipped with doors and hardware which vzill permit access from the outside in case of emergency. When such rooms have only one opening or are small, the doors shall be capable of opening outwards or to be otherwise designed to be opened V7Íthout the need to push against the patient who may have collapsed within the room.

(2) The minimum width of all doors to rooms needing access for beds or stretchers shall be 3'-8" (111.7 cm.). Doors to patient's toilet rooms and other rooms needing access for wheelchairs shall have a rainimum width of 2'-10" (86.3 cm.). (3) Doors on all openings between corridors and rooms or spaces subject to occupancy, except elevator doors, shall be swing type. Openings to showers, baths, patient toilets, and other wet-type areas not subject to fire hazard are exempt from this requirement.

(4) Doors, except those to spaces such as small closets which are not subject to occupancy shall not swing into corridors in a manner that might obstruct traffic flow or reduce the required corridor width. (Large walk-in type closets are considered as occupiable spaces.)

~~146 (5) Windows and outer doors that may be frequently left in an open position shall be provided with insect screens.~~

~~(6) Windows shall be designed so that persons cannot accidentally fall out of them when they are open, or shall be provided with security screens.~~

~~"^ (7) Lower window sills so that children can see out. Locate special windows at different heights for the specific use of children of different sizes.~~

(8) Doors, sidelights, borrowed lights, and windows in which glazing extends down to within 18 inches (46 cm.) of the floor (thereby creating possibility of accidental breakage by pedestrian traffic) shall be glazed with safety glass , wire glass, or plastic glazing material that will resist breaking and will not create dangerous cutting edges when broken. Similar materials shall be used in wall openings of recreation rooms and exercise rooms unless required otherwise for fire safety. Safety glass or plastic glazing materials shall be used for shower doors and bath enclosures.

~~(9) Elevator shaft openings shall be class B 1 1/2 hour labeled fire doors.~~

~~L NEN AND REFUSE CHUTES (1) Service openings to all chutes shall not be located in corridors or passageways but shall be iocated in a room of construction having a fire-resistance of~~

~~147 not iess than 1 hour. Doors to such rooms shall not be less than C--3/4 hour labeled fire doors.~~

~~(2) Minimum cross-sectional dimension of gravity chutes shall be not less than 2'-0" (61 cm.).~~

(3) Chutes shall discharge directly into collection rooms separate from incinerator, laundry or other services. Separate collection rooms shall be provided for trash or for linen. The enclosure construction for such rooms shall have a fire-resistance of not less than 2 hours, and the doors thereto shall be not less than class B 1 1/2 hour labeled fire doors. (4) Service openings to all chutes shali have approved seif-closing class B 1 1/2 hour labeled fire doors.

DUMBWAITERS AND CONVEYORS (1) Dumbwaiters, conveyors and material handling systems shall not open directly into a corridor or exit- way but shall open into a room enclosed by construction having a fire-resistance of not less than 1 hour and provided with class C 3/4 hour labeled fire doors. Service entrance doors to vertical shafts containing dumbwaiters, conveyors, and material handling systems shall be not less than class B 1 1/2 hour labeled fire doors for 2-hour walls and class C 3/4 hour labeled fire doors for 1-hour walls or partitions.

~~148 BATH AND HANDWASHING FACILITY SPECIALTIES~~

(1) Grab bars shall be provided at all patient's toilets, showers, tubs, and sitz baths. The bars shall have 11/2 inch (3.8 cm. ) clearance to walls and shall have sufficient strength and anchorage to sustain a concentrated load of 250 pounds (113.4 kg.).

~~(2) Recessed soap dishes shall be provided at shower and bath tubs.~~

(3) Location and arrangement of handwashing facilities shall permit their proper use and operation. Particular care should be given to the clearances required for blade- type operating handles. (4) Mirrors shall not be installed at handwashing fixtures in food preparation areas or in sensitive areas such as nurseries, clean and sterile supplies, and scrub sinks. Hang mirrors so that children can see themselves without climbing. (5) Provide raised tubs for bathing young children.

~~(6) Use child-size sinks and toilets. (7) Paper towel dispensers and waste receptacles shall be provided at all handwashing facilities except scrub sinks.~~

~~(8) Lavatories and handwashing facilities shall be securely anchored to withstand an applied vertical load of not less than 250 pounds (113.4 kgs.) in front of the fixture.~~

~~149 CE LING HE GHTS~~

~~(1) Boiler rooms shall have ceiling clearances of not 2'-6" (76 cm. ) above the main boiler header and connecting piping.~~

(2) P.adiographic, operating and delivery rooms, and other rooms containing ceiling-mounted equipment or ceiling-mounted surgical light fixtures shall have height required to accommodate the equipment or fixtures.

(3) All other rooms shall have not less than 8'-0" (244 cm.) ceilings except that corridors, storage rooms, toilet rooms, and other minor rooms shall be not less than 7'-8" (2.34 m. ) . Suspended track, rails, and pipes located in the path of normal traffic shall be not less than 6'-8" (2.03 m.) above the floor.

WASTE PROCESSING SERVICES (1) Space and facilities shall be provided for the sanitary storage and disposal of waste by incineration, mechanical destruction, compaction, containerization, removal or by a combination of these techniques.

(2) A gas, electric, or oil-fired incinerator shall be provided for the complete destruction of pathological and infectious waste. Infectious waste shall include, but shall not be limited to, dressings and material from open wounds, laboratory specimens, and all waste material from isolation rooms.

~~150 (a) The incinerator shall be in a separate room or placed outdoors.~~

~~(b) Design and construction of incinerator and trash chutes shall be in accordance with NFPA Standard 82.~~

~~(c) Incinerators shall be designed and equipped to conform to requirements prescribed by air pollution regulation in the area.~~

~~FINISHES~~

(1) Cubicle curtains and all draperies shall be non- combustible or rendered flame retardant and shall pass both the large and small scale tests of NFPA Standard 701. Use textured patterned materials. (2) Floors in areas and room in which flammable anesthetic agents are stored or administered to patients shall comply with NFPA Standard 56A. Conductive flooring may be omitted from emergency operating and delivery rooms providing that a written resolution is signed by the hospital board stating that no flammable anesthetic agents will be used in these areas and provided that appropriate notices are permanently and conspicuously affixed to the wall in each such area and room. (3) Floor materials shall be easily cleanable and have wear resistance appropriate for the location involved. Floors in areas used for food preparation or food assembly shall be water resistant and grease proof.

151 Joints in tile and similar material in such areas shall be resistant to food acids. In all areas frequently subject to wet cleaning methods, floor materials shall not be physically affected by germicidal and cleaning solution. Floors that are subject to traffic while wet (such as shower and bath areas, kitchens, and similar work areas)shall have nonslip surfaces.

(4) Wall bases in kitchens. operating and delivery rooms, soiled workrooms. and other areas which are frequently subject to wet cleaning methods shall be made integral and coved with the floor, tightly sealed within the wall, and constructed without voids that can harbor insects.

(5) Floor and wall penetrations by pipes, ducts, and conducts shall be tightly sealed to minimize entry of rodents and insects. Joints of structural elements shall be similarly sealed. (6) Ceilings shall be cleanable and those in sensitive areas such as surgical, delivery, and nursery rooms shall be readily washable and without crevices that can retain dirt particles. These sensitive areas along with the dietary and food preparation areas shall have a finished ceiling covering all overhead ductwork and piping. Finished ceilings may be omitted in mechanical and equipment spaces, shops, general storage areas, and similar spaces, unless required for fire resistive purposes

~~152 (7) Acoustical ceilings shall be provided for corridors in patient areas, nurses' stations, labor rooms, dining areas and wet areas.~~

~~CONSTRUCTION, INCLUDING FIRE-RES STIVE REQUIREMENTS~~

A. Design. Every buiiding and every portion thereof shall be designed and constructed to sustain all dead and live loads in accordance with accepted engineering practices and standards, including seismic forces if they apply.

B. Foundations. Foundations shall rest on natural solid bearing if a satisfactory bearing is available at reasonable depths. Proper soil bearing values shall be established in accordance with recognized standards. If solid bearing is not encountered at practical depths, the structure shall be supported on driven piles or drilied piers designed to support the intended load without detri- mental settlement, except that one-story buildings may rest on a fill designed by a soil engineer. All footings shall extend to a depth not less than I'-O" (30.5 cm.) below the estimated maximum frost line. C. Constructíon. Construction shall be in accordance with the requirements of section 10-132 of NFPA Standard

~~101. D. Freestanding Buildings. Separate free standing buildings housing the boiler plant, laundry shops may be of unprotected non-combustible construction, protected~~

~~153 non-combustible construction or fire-resistive construction.~~

E. Enclosures. Enclosures for elevator shafts, chutes and other vertical shafts, boiler rooms and storage rooms of 100 square feet (9.29 meters) or greater shall be of construction having a fire-resistance rating of not less than 2 hours.

F. Insulation Materials. Building insulation materials, unless sealed on all sides and edges, shall have a flame spread rating of 25 or less and a smoke development rating of 150 or less when tested in accordance with ASTM Standard

~~E84. G. Provisions for Natural Disasters.~~

~~(1) General requirements. An emergency radio communication system shall be provided in each facility.~~

~~This system will be self-sufficient in time of emergency~~

~~and capable of operation without reliance on the build-~~

~~ing's service or emergency power supply-~~

~~ELEVATORS All hospitals having patient's facilities (such as~~

~~bedrooms, dining rooms, or recreation areas) or critical~~

~~services (such as operating, delivery, diagnostic or~~

~~therapy) located other than the main entrance floor shall~~

~~have electric or electrohydraulic elevators.~~

154 (1) At least two hospital-type elevators shail be installed where 60 to 200 patient beds are located on floors other than the main entrance floor, or where the major in-patient services are located on a floor other than those containing patient beds. (Elevator service may be reduced for those floors which provide only partial patient services.)

(2) Cars and platforms. Cars of hospital-type elevators shall have inside dimensions that will accommodate a patient bed and attendants and shall be at least 5'-0" (1.52 m. ) wide by 7'-6" (2.29 m.) deep. The car door shall have clear opening of not less than 3'-8" (1.12 m.).

(3) Leveling. Elevators shall be equipped with an automatic leveling device of the two way automatic maintaining type with an accuracy of ± 1/2 inch (± 1.3 cm. ) . (4) Operation. Elevators, except freight elevators, shall be equipped with a two-way special service switch to permit cars to bypass all landing button calls and

~~be dispatched to any floor.~~

~~(5) Elevator controls, alarm buttons and telephones~~

~~shall be accessible to wheelchair occupants.~~

~~(6) Elevator call buttons, controls and door safety~~

~~stops shall be of a type that will not be activated by~~

~~heat or smoke.~~

~~155 MECHANICAL REQUIREMENTS~~

~~A. Thermal and Acoustical nsulatlon.~~

~~(1) Insulation shall be provided for the following within the building:~~

~~a. Boilers, smoke breeching, and stacks.~~

~~b. Steam supply and condensate return piping. c. Hot water piping above 180 F (82 C) and all hot water heaters, generators and convertors.~~

d. Hot water piping above 125 F (52 C) which is exposed to contact by patients. e. Chilled water, refrigerant, other process piping and equipment operating with fluid temperatures below ambient dew point. f. Water suppiy and drainage piping on which condensation occurs. g. Air ducts and casings with outside surface temperature below ambient dew point.

~~(2) Insulation on cold surfaces shall include an~~

~~exterior vapor barrier.~~

~~(3) Linings in air ducts and equipment shall not be used in systems supplying operating rooms, delivery rooms, recovery rooms, nurseries and intensive care units unless terminal filters of~~

~~at least 90 percent efficiency are installed down-~~

~~stream of linings.~~

~~156 B. Steam and Hot Water Systems.~~

(1) Boilers. Boilers shall have the capacity, based upon the net ratings published by the Hydronics Institute, to supply the normal requirements of all systems and equipment. The number and arrangement of boilers, shall be such that, when one boiler breaks down, or routine maintenance requires that one boiler be taken out of service, the capacity of the remaining boilers shall be sufficient to provide hot water service for clinical, dietary and patient use; steam for sterilization and dietary purposes; and heating for operating, delivery, labor, recovery, intensive care, nursery and general patient rooms, except that heating of general patient rooms is not required in areas with a design temperature of 20 F (-7 C) or

more, based on the Median Extremes in the ASHRAE Handbook of Fundamentals. (2) Boiler accessories. Boiler feed pumps, heating circulation pumps and fuel oil pumps shall be connected and installed to provide normal and standby service.

~~C. Air Conditioning, Heating and Ventilating Systems. (1) Temperature and humidities:~~

~~a. The systems shall be designed to provide a~~

~~minimum design temperature of 75 F (24 C)~~

~~157 at winter design conditions unless otherwise noted in the detailed space list. (2) Ventilation system details. All air-supply and~~

~~air-exhaust systems shall be mechanically operated. All fans serving exhaust systems shall be located at the discharge end of the system.~~

a. Outdoor intakes shall be located as far as practical but not less than 25'-0" (7.62 m. ) from exhaust outlets of ventilating systems, combustion equipment stacks, medical-surgical vacuum systems, plumbing vents stacks, or from areas which may collect vehicular exhausts or other noxious fumes. The bottom of outdoor air intakes serving central systems shall be located as high as practical but not less than 6'-0" (1.83 m.) above ground level, or if installed above the roof 3'-0" (91 cm.) above the roof level. b. All air supplied to operating rooms, delivery rooms and nurseries shall be at or near the ceiling of the area served, and all exhaust air from the area shall be removed near floor level. At least two exhaust outlets shall be used in all operating and delivery rooms.

~~c. The bottoms of ventilation openings shall be not less than 3 inches (7.6 cm.) above the~~

158 floor of any room. d. Corridors shall not be used to supply air to or exhaust air from any room, except that air from corridors may be used to ventilate bathrooms, toilet rooms, janitor's closets, and small electrical or telephone closets opening directly on corridors. e. Isolation rooms and intensive care rooms may be ventilated by induction units if the induction units contain only a reheat coil and only if the primary air supplied from a central system passes through the reheat coil. f. Ducts which penetrate construction intended for x-ray or other ray protection shall not impair the effectiveness of the protection. g. Fire and smoke dampers shall be constructed, located and installed with the requirements of NFPA Standard 90 A, except that all systems, regardless of size, which serve more than one smoke or fire zone, shall be equipped with smoke detectors to shut down fans automatically- Access for dampers shall be provided at all dampers.

~~Supply and exhaust ducts which pass through a required smoke barrier and through which smoke can be transferred to another area shall~~

~~159 be provided with dampers at the barrier controlled to close automatically to prevent flow of air or smoke in either direction when the fan, which moves air through the duct, stops.~~

Return air ducts which move air through a required smoke barrier shall be provided with a damper at the barrier activated by smoke or product combustion (other than heat) detectors. Laboratory hoods shall meet the following general requirements: (i) Have an average face velocity of not less

~~than 75 feet per minute (0.38 meters per~~

~~second). (ii) Be connected to an exhaust system which is separate from the building exhaust system. (iii) Have an exhaust system which is separate~~

~~from the building exhaust system.~~

~~(iv) Have an exhaust duct system of non- combustible corrosion-resistant material~~

~~as needed to meet the planned usage of~~

~~the hood. Exhaust hoods in food preparation centers shall have an exhaust rate of not less than 50 cfm per square foot (0.25 cubit meters~~

160 per second per square meter) of face area. Ail hoods over cooking ranges shall be equipped with grease filters, fire extin- guishing systems and heat-actuated fan controls. Cleanout openings shall be provided every 20'-0" (6.10 m.) in horizontal exhaust systems serving these hoods.

j. The ventilation system for anesthesia storage rooms shall conform to the requirements of NFPA Standard 56A, including the gravity option. k. Boiler rooms shall be provided with sufficient outdoor air to maintain combustion rates of equipment and to limit temperature in working areas to 97° F (36° C) effective temperature. E. Plumbing and Other Piping Systems. (1) Plumbing Fixtures: a. The materials used for plumbing fixtures shall be nonabsorptive acid resistance material.

b. The water supply spout for lavatories and sinks required in patient care areas shall be mounted so that its discharge point is a minimum distance of 5 inches (12.7 cm. ) above the rim of the mixture. All fixtures used

~~by medical and nursing staff and all lavatories~~

~~used by patients and food handlers shall be~~

161 trimmed with valves which can be operated without the use of hands. Where blade handles are used for this purpose, they shall not exceed 4 1/2 inches (11.4 cm.) in length, except that handles on scrub sinks and clinical sinks shall not be less than 6 inches (15.2 cm.) long. c. Shower bases and tubs shall provide nonslip surfaces for standing patients. (2) Water supply sustems:

a. Systems shall be designed to supply water at sufficient pressure to operate all fixtures and equipment during maximum demand periods, b. Each water service main, branch main, riser, and branch to a group of fixtures shall be valved. Stop valves shall be provided at each fixture.

c. Backflow preventers (vacuum. breakers) shall be installed on hose bibs, laboratory sinks, bedpan flushing attachments, autopsy tables, and on ali other fixtures to which hoses or tubing can be attached.

~~d. Bedpan flushing devices shall be provided in each patient toilet room.~~

~~e. Water distribution systems shall be arranged~~

~~to provide hot water at each hot water outlet~~

~~162 at all times. Hot water at shower, bathing, and handwashing facilities shall not exceed 110° F (43° C).~~

~~(3) Hot water storage tanks shall be fabricated of corrosion-resistant metal or lined with non- corrosive materials. (4) Drainage systems:~~

a. Drain lines from sinks in which acid wastes may be poured shall be fabricated from acid resistant material. b. Insofar as possible, drainage piping shall not be installed within the ceiling nor installed in an exposed location in operating and delivery rooms, nurseries, food preparation centers , food serving facilities, food storage areas and other critical areas.

c. Floor drains shall not be installed in operating and delivery rooms. d. Building sewers shall discharge into a community sewerage system. l^Jhere such a system is not available, a facility providing sewage treatment conforming to applicable local and State regulations must be provided.

~~(5) Nonflammable medical gas system. Nonflammable medical gas system installations shall be in accordance with the requirements of NFPA 56A and 56F.~~

~~163 (6) Clinical vacuum (suction) systems. Clinical vacuum systems installations shall be in accordance with the requirements of Compressed Gas Association Pamphlet No. P-2.1.~~

~~(7) Central housekeeping vacuum systems. Service outlets for central housekeeping vacuum systems, if used shall not be located within operating rooms.~~

~~ELECTR CAL REQUIREMENTS A. General.~~

All material including equipment, conductors, controls and signaling devices shall be installed to provide a complete electrical system with the necessary characteristics and capacity to supply the electrical facilities required. All materials shall be listed as complying with available standards of Underwriter's Laboratories, Inc, or other similarly established standards.

B. Switchboards and Power Panels. Circuit breakers or fusible switches that provide disconnecting means and overcurrent protection for conductors connected to switchboards and panel boards shall be enclosed or guarded to provide a dead-front type of assembly. The main switchboard shall be located in a separate enclosure accessible only to authorized persons. The switchboards shall be convenient for use, readily accessible for maintenance, clear of traffic lanes, and

~~164 in a dry ventilated space free of corrosive fumes or gases.~~

~~C. Panelboards.~~

~~Panelboards serving lighting and appliance circuits shall be located on the same floor as the circuits they serve. This requirement does not apply to emergency system circuits.~~

~~D. Lighting.~~

~~(1) All spaces occupied by people, machinery, and equipment within buildings, approaches to buildings, and parking lots shall have lighting.~~

(2) Patients' rooms shall have general lighting and night lighting. A reading light shall be provided for each patient. At least one light fixture for night lighting shall be switched at the entrance to each patient room. (3) Operating and delivery rooms shall have general lighting in addition to local lighting provided by special light units at the surgical and obstet- rical tables. Each fixed special lighting unit at the tables, except for portable units, shall be connected to an independent circuit.

~~E. Receptacles (convenience outlets). (1) Anesthesizing locations. Each operating and delivery room shall have at least three receptacles of the types described in NFPA Standard 56A. In~~

~~165 locations where mobile x-ray is used, an additional receptacle marked for x-ray use shall be provided.~~

(2) Patients' rooms. Each patient room shall have duplex grounding type receptacles as follows: one located on each side of the head of the bed of each bed; one for television, if used; and one in another wall. Nurseries shall have not less than one receptacle for each bassinet.

(3) Corridors. Duplex receptacles for general use shall be installed approximately 50'-0" (15.24 m.) apart in all corridors and within 25'-0" (7.62 m.) of ends of corridors. Single polarized receptacles marked for use of x-ray equipment only shall be located in corridors of patient areas so that mobile equipment may be used in any location within a patient room without exceeding a cord length of 50'-0" (15.24 m. ) attached to equipment. If the same mobile x-ray unit is used in operating rooms and in nursing areas, all receptacles for x-ray use shall be of a configuration that one plug will fit the receptacles in all locations.

~~Nurses' Calling System. (1) General. In general patient areas, each room shall be served by at least one calling station and each bed shall be provided with a call button. Two~~

~~call buttons serving adjacent beds may be served~~

166 by one calling station. Calls shall register with floor staff and shall actuate a visible signal in a corridor at the patients' door, in the clean workroom, the soiled workroom, and the nourishment station of the nursing unit. Nurses' calling systems which provide two-way voice communication shall be equipped with an indicating light at each calling station which lights and remains lighted as long as the voice circuit is operating.

(2) Patients' emergency. A nurses' call emergency button shall be provided for patients' use at each patient's toilet, bath, sitz bath, and shower room. (3) Intensive care. In areas such as intensive care where patients are under constant surveillance, the nurses' calling system may be limited to a bedside station that will actuate a signal that can be readily seen by the nurse. (4) Nurses' emergency. An emergency calling station which may be used by nurses to summon assistance shall be provided in each operating, delivery, recovery, emergency treatment, and intensive care room, in nurseries, and in supervised nursing units for mental patients.

~~H. Emergency Electric Service. (1) General. To provide electricity during an~~

~~167 interruption of the normal electric supply, an emergency source of electricity shall be provided and connected to certain circuits for lighting and power.~~

~~(2) Sources. The source of this emergency electric service shall be as follows:~~

~~a. An emergency generating set when the normal service is supplied by one or more central transmission lines.~~

b. An emergency generating set or a central transmission line when the normal electric supply is generated on the premises. (3) Emergency generating set. The required emergency generating set, including the prime mover and generator, shall be located on the premises and shall be reserved exclusively for supplying the emergency electrical system. Exception: A system of prime movers which are ordinarily used to operate the emergency generator(s) will be permitted provided that the number and arrangement of the prime movers are such that when one of them is out of service (due to breakdown or routine maintenance) the prime mover(s) can operate the required emergency generator(s).

~~(4) Emergency electrical service shall be provided to the distribution system as follows:~~

~~168 Circuits for the safety of patients and personnel.~~

~~(i) Illumination of means of egress.~~

~~(ii) Illumination for exit signs and exit directional signs.~~

(iii) Alarm systems including fire alarms activated at manual stations, water flow alarm devices of sprinkler system if electrically operated, fire and smoke detecting systems, and alarms required for nonflammable medical gas systems if installed.

(iv) Paging or speaker systems if intended for communication during emergency- Radio transceivers where installed for emergency use shall be capable of operating for at least one hour upon total faiiure of both normal and emergency power. (v) General illumination and selected receptacles in the vicinity of the generator set. Circuits essential to care, treatment and protection of patients. (i) Task illumination and selected receptacles

~~in infant nurseries; medicine dispensing~~

169 areas; cardiac catheterization laboratories; angiographic laboratories; labor, operating and delivery and recovery rooms; dialysis units; intensive care areas; emergency treatment rooms; and nurses' stations. c. Circuits which serve necessary equipment. The connection to the following emergency electric services shall be delayed automatic except for heating, ventilation and elevators which may be either delayed automatic or manual:

(i) Equipment for heating, operating, delivery, labor, recovery, intensive care, nursery, and general patient rooms will not be required under the following conditions: (aa) if the design temperature is higher than 20° F (7°C), or (bb) if the hospital is served by two or more electrical services supplied from separate generators or a utility distribution network having multiple power input sources and arranged to provide mechanical and electrical separation so that a fault between the hospital and the generating sources will not likely cause an interruption of the hospital service feeders.

170 (ii) Elevator service that will reach every patient floor. Throw-over facilities shall be provided to allow temporary operation of any elevator for the release of persons who may be trapped between floors.

~~(iii) Ventilation of unfenestrated operating and delivery rooms.~~

~~(iv) Central suction systems serving medical and surgical functions. (v) Equipment must be kept in operation to prevent damage to the building or its contents.~~

Source: Minimum Requirements of Construction and Equipment for Hospital and Medical Facilities. U.S. Department of Health, Education and Welfare. Health Resources Administration. Bethesda, Maryland. 1975. UNLESS OTHERWISE NOTED, Planning and Design for Perinatal and Pediatric Facilities, Donalds Basler, H.H.A,, M.A,C.H.A. Library of Congress #77-82725. 1977.

~~171 COST ANALYSIS~~

~~172 PROJECT DEVELOPMENT COST ESTIMATE~~

~~The foIIovd.ng cost estimate is a prelirainary prediction of the probable~~

~~cost of the project. It is bases on prograra requireraents and current, local~~

~~raarket conditions in terms of materials, labor and other economic factors.~~

~~The elements of the project developraent cost estiraate include:~~

* Building construction cost estiraate

* Site developraent cost estiraate

* Project cost

* Contingent

~~Although this is a rough predesign cost estiraate, cost estimate~~

~~revisions should be sheduled for each plase of work completion; e.g,, program~~

~~scheraatic design, design development, construction documents.~~

~~173 SPACE SUMMARY~~

~~Total Net Bldg. Area~~

~~Administration 7,149 Sq. Pt.~~

~~Nursing Unit 26,649 Sq. Ft.~~

~~Intensive Care Unit 2,371 Sq. Ft.~~

~~Surgical Suite 3,421 Sq. Pt.~~

~~Hîiergency Departraent 1,545 Sq. Pb,~~

~~Auxiliary Support 3,473 Sq. Pt.~~

~~Pharmacy Deparmtnet 1,120 Sq. Ft.~~

~~Morgue Room 1,137 Sq. Ft.~~

~~Food Service & Distribution 4,560 Sq. Ft.~~

~~Laundry Services 4,345 Sq. R,~~

~~S iployee's Facilities 1,322 Sq. Pt.~~

~~Storage Facilities 5,230 Sq, Ft,~~

~~Srrvice Area 7^056 Sq.Ft.~~

~~Total,,. 69,378 Sq. Ft.~~

~~Total Gross Area~~

~~Total Net Area = Total Gross -'lrea NET to gross ratio~~

~~69.378 121,715.79 Sq.Ft. .57 = 174 BUILDING GONSTRUCTION GOST ESTI 'iATE~~

~~Building costs were derived by a unit cost method applied to the various program elements, and break dovm as follovís:~~

Building System Ave.-#/Sq. Ft. Ave. jo Tot.Gost. Foundations 3.56 3.09 Substructure 1.28 I.ll Superstructure 13.18 11.46 Exterior closure 8.68 7.55 Roofing 2.10 1,82 Partions 10.03 8.72 Wall finishes 2.66 2.31 Floor finishes 2.46 2.14 Geiling Finishes 2,36 2.05 Specialties 2.46 2.14 Conveying Systeras 3.05 2.65 Plurabing 11.23 9.76 Fire Protection .76 .66 HVAC 21.00 18.26 Electrical 17.58 15.29 General Conditions 5.46 4. (!-•

~~Net Building Cost 108.15 93.75 Equipraent 6.80 5-92~~

~~Gross Building Cost 114.95 (4/82) 100,00~~

175 Site Developraent Cost Estimate The folloxd.ng asumptions v/ere made to arrive at a reasonable sitc develo'pment cost; * Site is at IH-IO and Caper St. * Glear Acre - 0 - * Site preparation $263,340 1,5',. 3 Building cost ^On site utilities $17.'-,893 I/o Builcin^ cost * Sidewalks $218, :Sl7 I.25,;j building cost * Landscaping $262,340 1.5'^ building cost * Outdoor lighting $3/,9,787 2fo building cost * Fixed equip.ment $87', 4o8 5/j building cost * Parking 300 spaces © 5,30 Sq.Yd (209 X 300=02,700 $332,310 62,700 Sq.yd. X 5.30) Total Site Development '^^'^-^-•^--•,75^

~~1% Sscalation~~

~~3/84 ;Snd Program Schematic D. Development Const. Docu. I Construction 4/82 9/82 3/83 6/83 12/84 1~~

~~I Escalation 1% month X 25 months -25;í ' Midpoint ^ Construction~~

* Dodge builcîing cost calculator and valuation guide, Oct-Dec.1981

~~Gross Cost/Sq.Ft. Escalation Cost/Sq.Ft. Buil'iin:: Sq.Ft. 4/82 mid-pt.Const 3/84 Cost~~

~~121,716 m.95 25fo 143.69 17,489,572~~

~~Total Building Cost IT.^VGS .372~~

177 Pro.ject Cost j A ii":ure of 25,.;Í is added to the sum of building construction and site development costs to cover professional fees, lurniture, furnishings, legal fees and administrative costs such as msurance. 12

~~Total Site Development $19,964,127 and building Construction Cost 25}. $ 4,999,031 $24,955,158~~

Contingency At this stage of project development a IC^ contingency should be added to the project cost to allow for minor ad.justments in pro^rarn, varlables in square foot price and unusual construction conditions not foressen at this 18 time' .

~~Project Cost $2L,955,I58 lOfo Gontingency $ 2,495,515 Total $27,450,673~~

~~Estimated probable 327,450,673 Construction Cost.~~

~~178 0:, M IB:~~

~~'Jr L:* >- -. J L~~

~~DETAILED SPACE LIST' INTRODUCTION~~

~~The purpose of this guide is to assit in arriving at a good design~~

~~careful design can conserve space, but space should not be conserved at~~

~~the expense of efficiency, The guide is composed of subsections consisting~~

~~of elements of the departments or of a particular unit, followed by a des-~~

~~cription of the functions of the unit and other pertinent information, Each~~

~~component element of the iinit follows thereafter in sucession, and for each~~

~~the following are given:~~

~~FUNCT QN-Explains the purpose of or the acti^vlty accomplished within the~~

~~component roora or area,~~

~~OCGUPANCY- ndicates the person or persons assigned routinely to the roora~~

~~and raaximura occupancy anticipated.~~

~~ADJACENT ARKA- Together vjith the plan or dLLagraras for the unit, vd.ll assist~~

~~j- in relating one room or area to another.~~

~~ARGHITECTURAL CONSIDERATION- The architectural consideration are divided into~~

~~sections, and they are of vital iraportance. Lighting is critical; the~~

~~footcandles at task level should be carefiiLly selected. Either excessive~~

~~or inadequate lighting is harraful. The electrical includedes outlets and~~

~~plugs for the electrical appliances. HVAC is the raechanical considerations~~

~~include air conditioning, where job or equipment conditions require it, or~~

~~heating requirements,~~

~~The design of all the areas of the children's to the handicapped.~~

~~Handicap commodities should be an integrated part of the program and~~

~~180 design, In addition it may be desirable to install mechanically activated doors, provided they are equipped våth emergency manual operations.~~

~~181 MAIN PUBLIC ENTRANCE AND LOBBY AREA~~

~~# Room Eleraents Net Sq,Ft,Required~~

~~001 Entrance & Lobby Area 675~~

~~002 Main Public Entrance 100~~

~~003 Retiring Facility 200~~

~~004 Gift shop & Snack Shop 320~~

~~005 Play Area 500~~

~~006 Public Restroom 220 2,015 Sq.Pt.~~

~~182 MAIN ENTRANCE AND LOBBY AREA~~

~~The main lobby of the hospital is used primarily to accoraraodate patients and members of their families. Patients usually enter the hospital~~

~~•via the main lobby and are dichcarged there,so a good favorably impression~~

~~is raust iraportant. the raain lobby area is coraposed of five subarias.~~

~~(see diagrara of raain entrance and main lobby area).~~

~~MAIN ENTRANCE TO HOSPITAL~~

~~183 DIAGRAM OF PARKING RELATIONSHIPS~~

The raain public entrance should be conveniently near to the public parking area. The design of this coraponent should pro'vide' protection from the weather while acting as a transition space frora the víeather.

~~(see parl-cing (ilagram of parking) People vri.sh to come into the entrance nearest their assigned parking, and the site plan should so allow.~~

~~( DOCTORS 1 SERVICE l PARKING /~~

~~^ HOSPITAL~~

~~NOTE' 200 PARKINe 3PACE3 ARE NEEDEO~~

~~184 FACILITY NO. ooi DESCRIPTION Ehtrance and Lobby Area NO. OF UNITS NO. OF OCCUPANTS 48 NET AREA 675 Sg. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~The main lobby of the hsopital will be used to accommodate the~~

~~children, merabers of their families and friends. It also serves persons~~

~~whose destination is in the adrainistrative areas. Physicians may use it~~

~~when it pro^vides the most convenient access route to or frora areas they~~

~~vdsh to contact upon entering or lea"ving the hospital, such as the Me-~~

~~dLcal Record Departament or doctor in-and-out register.~~

~~Ghildren, unless entering via emergency, usually vd.ll enter the~~

~~hospital 'via the main lobby and are ciischarged there, The lobby must~~

~~pro^vide a favorable impression, For example, in the Texas Scottish~~

~~Rite Hospital a hu,ge mobile was hung in the hospital's lobby, combining~~

~~color, motion and imagination to hold the attention of children and~~

~~adults alike.~~

~~OCCUPANCY:~~

~~Space provision for 48 persons and chindren .occupying this area~~

~~during visiting and acîmitting hours must be made ,~~

~~ADJACENT AREAS~~

~~The main looby should be convenient to the stairs, corridors and eleva~~

~~tors leading to patient areas, It also should be adjacent to the administra~~

~~tive block and the admitting Department.~~

~~ARGHITECTURAL CONSIDERATIONS~~

~~Lighting: Standard 185 Electrical: Standarc~~

~~HVAC: Standard~~

~~Walls: Standard~~

~~Floors: Standard~~

~~Ceiling: Standard~~

~~Gomraunication: Public telephone outlets should be pro^vided. Masterphone at information center.~~

~~Plumbing: Water outlets and drain for water couler should be provided.~~

~~FURNITURE/BQUIPMENT:~~

~~20- Chairs (sfectional type, shell type and arm)~~

~~7- Tables (round, coffee, sectional)~~

~~3- Drinking receptacle.~~

~~Notes;~~

~~The interior design of the entrance and lobby area id.ll be open space vdth~~

a commuru.ty atmosphere. It must be designed vdth the cliildren's scale in mind. It raustinclud e intersting shapes and, if at all possible, mobiles hanging from the ceiling, paintings, murals, or planters.

~~186 FACILITY NO. 002 DESCRIPTION ]v533_n Public Entrance NO. OF UNITS NO. OF OCCUPANTS varies NET AREA loo Sg, Ft.~~

~~GOMI^'îEIW - The interior design of the entrance and lobby area ,vdll vary~~

~~with style and taste and may inclucle memorals or commemora-~~

~~tive plaques, paintin'-is, murals, and planters,~~

~~FUNGTIONAL DESCRIPTION~~

~~This component should provide protection from the elements vjldle acting~~

~~information center vdll be integrated with the financial management unit,~~

~~as a transition space from the outdoors. It should be especially accessible~~

~~to the ramp for handicapped patients and the lobby area. This area -~~

~~represfents the hospital's character, so it is of prime importance,~~

~~OCCUPANCY~~

~~The children and parents vdll occupy or pass by the area v;ldle walking~~

~~in or out 01 the building.~~

~~ADJACENT AREA~~

~~The main entrance should be convenient by located to the parking area~~

~~or a porte cochere. It should be just off the main lobby.~~

~~ARCHITEGTURAL CONSIDSRATIONS~~

~~Lighting: Standard~~

~~ELectrical: Standard~~

~~HVAC: Standard~~

~~Walls: Standard~~

~~Floors: Standard~~

~~NOTE: A vestibules must be provided for all entrances. 187 FACILITY NO. 003 DESCRIPTION Retiring Facility NO. OF UNITS 1 NO. OF OCCUPANTS ^^ NET AREA 200 Sg, Ft,~~

~~FUNCTIONAL DESCRIPTION~~

~~This facility is used to accommodate anxious or bereavec relatives,~~

~~It may serve also as a center for •visiting chaplains. A storage or closet~~

~~area should be pro"vided.~~

~~OCGUPANCY~~

~~The retiring facility idll to be occupied by members of the immecdate~~

~~family suffering the death of a love one, and a chaplain.~~

~~ADJACEITT AREAS~~

~~The retiring room should be off the main lobby, near the iniormation~~

~~center. Restrooms facilities should be available.~~

~~ARCHITECTURAL GONSIDERATIONS~~

~~Lighting: Standard~~

~~Electrical: Standard. Light dimraers on svdtches should be provided.~~

~~Acoustical: Standard~~

~~HVAG: Standard~~

~~Communications: Standard~~

~~Víalls: Standard~~

~~Floor: Standard, carpeting shoold be used.~~

~~188 FACILITY NO. 004 DESCRIPTION Gift Shop and Snack Shoo NO. OF UNITS ^ NO. OF OCCUPANTS 15-20 NET AREA 320 Sn. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~The coffee shop and gift shop can be combined since both are usually~~

~~operated by the women's auxiliarj'-. Flower shops, which require refrigerated~~

~~storage, are soraetimes combined vdth gift shops. The gift shop does not~~

~~reauire the transportation of food and food waste, but the coffee sitop'does~~

~~require food handling.~~

~~OCCUPANCY~~

~~The maxiraurn capacity will be between 15-20 occupants, the raaximum~~

~~peak point is during -visiting hours.~~

~~ADJACENT AREAS~~

~~The best location is off the main lobby in a conspicuous location~~

~~with on adequate Display area and, if possible, close or adjacent to the~~

~~regular cafeteria.~~

~~ARGHITECTURAL CONSIDERATIONS~~

~~Lighting: Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Floors: Standard~~

~~Ceiling: Standard~~

~~Communication: Standard~~

~~Plurabing: Water outlets and drainage for various equipment. ProvLde sterile~~

~~189 hot and cold water. Pro'vide floor draw in the snack area.~~

~~FURNITURE/SQUIPMENT~~

~~15- Chairs~~

~~1- Long snack type counter~~

~~Display counters~~

~~I- Flower refrigeration unit.~~

~~190 FACILITY NO. 005 DESCRIPTION Play Area NO. OF UNITS 1 NO. OF OCCUPANTS 8=10 NET AREA 500 So, Ft.~~

FUICTIONAL DESCRIPTION A playground must challenge children to raaintainthei r interest and participation. The play equipraent should allow the child to challange hiraself physically and to expand self-understanding. Play equipraent should be designed and selected to raeet the physical and intellectual requirements of groups that will use it. Several basic forms, such as toys and animals, may be used to create play equipment, Some of these forms may be seen in the vdde range 01 manufacturers products available, The greater the variety of combinations in which these forms are used, The more options for play are available to the child. OCCUPANCY Occupants should be between ieght and ten chindren. ADJACENT AREAS Since parental observation is required, the play area must be adjacent to the raainlobby . It shoiild not overshadow the lobby but should harmaniously. blend with the lobby/seating area. ARGHITBCTURAL GONSIDERATIONS Lighting: Standard, Skylights and solariums should be used to bring sunlight and blue sky into the area.

~~191 Electrical: Standard~~

~~HVAC: Standard~~

~~Walls; Standard~~

~~Floors: Standard~~

~~Ceiling: Standard~~

~~Gomraunications: Standard~~

~~Plurabing: Water outlets and drain for water cooler should be provided.~~

~~The water cooler should be scaled for children's use.~~

~~NOTES: A toy closet or shelves are needed. If possible, the play area~~

~~should adjoin the outdoor play area.~~

~~192 FACILITY NO. 006 DESCRIPTION Public Restroom (men and women) NO. OF UNITS 2 W 110 Sq. Ft. (men) NO. OF OCCUPANTS , ^' i^° ^^' ^' ^"°'"^'^) NET AREA 220 Sg. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Restrooms should be so located that -vlsitors, patients, and others do~~

~~not have to go beyond the area controlled by the information center. They~~

~~should be usable by physically handicapped individuals, including those~~

~~in wheel chairs,~~

~~ADJACENT AREAS~~

~~Restrooms should be adjacent to the main lobby area. They should be~~

~~located before the information center,~~

~~ARGHITECTURAL CONSIDERATION~~

~~Lighting: 30 foot candles, non-clare, non-heat producing. Overhead lightin-~~

~~is required, Additional iighting required.~~

~~over lavatories and mirroTs.~~

~~Electrical: Gonvenience outlets should be provided for electrical apoliances~~

~~and fixtures.~~

~~HVAG: Minimum. Design temperature of 75°F (24°)shouÍd be a assumed minimura of six air changes per hour supplies to room.~~

~~Plumbing: Water supply and drain lines should be provided for lavatories,~~

~~water closets and urinals. Floor drain should be providec.~~

~~Walls: sound absorbing, cleanable, durable, water anc moisture resistant~~

~~materials should be used. Cerajnic tile is highly recoirxienc.ed.~~

~~193 Floors: Cleanable, resistant to hea"vy traffic, víater proof, moisture proof, slip resistant materials should be usec, Ceramic tile is recommended,~~

~~Geiling: Light reflecting, sound absorbing system with capability of incorporating hvac ducts, grilles and lighting fixtures should be used.~~

~~FURNITURE/.EQUIPMENT~~

~~Men: 1 Toilet~~

~~2 Urinals (one lov/er for children's scale)~~

~~2 Lavatories (one lowererd for children's scale)~~

~~Women: 3 Toilets~~

~~2 Lavatories (one lov/ererd for children's scale)~~

~~194 OTHER FACILITIES~~

Additional facilities or areas such as public phones, circulation, telegraph offices, and coatroom are integrated and provided in conjunction with main lobbies. The circulation is usually hea^viest for main lobby areas on Monday through Friday from approximately 10:00 a.tn. to 8:00 p.m.

~~Traffic is usally greatest on v/eekends. Normally, this area should not be less than one-third of that required for 'bhe Lounge-waiting area and not less than 200 square feet.~~

~~195 ADMINISTRATIVE BLOCK~~

The administrative block of the hospital is under the direction of the hospital ac3mird.strator. He has complete responsibility for the total activity and operation of the hospital, (refer to Administrative Block Chart), The block raustb e available to authorized visitor traffic and should be conveniently accessible to the hospital's main entrance and the vertical and horizontal comraurdcation areas. VJherever possible, the block should be adjacent to the raainlobb y to avoid lengthy hospital traffic pattems. Because the Administrative block is a work area, careful attention to lighting, acoustic, and environmental control is reqtdred. Every planrdng effort should be made to elirainate cross trafic. The administrative block may be a one-story wing extension of the main hospital vdth a structual module different from

that of the main building, Some advantage of the one-story wing concept in contrast to incorporating the block within the main hospital are increased opportunity for outside windows and independent exit to the outside. The administrative block should feature the following internal unit relationships: * All units should be located one to another vdth respect to their ffiutiaal relationships and activities. * Units generating the most traffic should be located nearest the main lobby. For example, the cashier and credit services of the

~~196 * Gives tours to familiarize the child idth the hospital and explains~~

~~regulations,~~

* Explains rates, charges, services and hospital policy.

* May interview parents to determine income.

* Obtains signature of indi^vidual responsible lor payment.

~~Patients, parents, mecdcal staff, and admittin clerks vdll be primary users of this area.~~

~~The admitting department should be directly accessible from the lobby~~

•via a corridor (see administrative block). In addition, certain components of financial manageraent should be directly accessible to the admitting department. If possible the patter should be located to serve all patients' admissions to the hospital-inpatient, outpatient, and emergency. Centering the entire admitting responsibility in one undt rather than in a number of units is obvidusly more economical in terms of personnel.

~~Incoming childi^en,' and sometiraes even the parents, are frequentlj^ in~~

197 a state of emotional tension and confusion. Hence, The Admitting Department should be reacdly d.dentifiable from the main entrance and from the information center. The department should be contin,^uous vdth the hospital's main lobby, particulary the iounge area, so that relati'vies may wait comfortably while the child is being admitted. Public telephones and restrooms should be converdently available to the Admitting Department.

Because of certain working relationship and interdependent responsibilities between the Adraitting and Medical Record Departament, the - operating efficiency of both m.11 be improved if they are located adjacent to each other. This vdll result in greater efficiency.

~~198 ADMITTING DEPARTMENT~~

~~# Room Eleraents Net Sq.Ft. Required~~

~~007 Admitting Desk Area 132~~

~~008 Office and cubicles 328~~

~~009 Work Area 215~~

~~010 Machine Roora 140~~

~~011 Wheelchair alcove 25~~

~~012 Coatroom 42~~

~~013 Restroom _30 912~~

~~199 ADMITTING DEPARTMENT~~

The primary function of the Admitting department is to adnit patients to the hospital in accordance vdth policies and re,gulations established by the Governing Board and Executive Unit, to promote good relationships with childrens, parents, relatives and raedicalstaff , and to satisfy community needs. Follovdng is a list of specific functions assigned to ArJrdtting

~~Officers, How or to what extent these apply in a specific situation depends on the admission policies and orgardzational controlling.factors of the particular hospital involved:~~

* Records iniormation identifying physician and patients, type of

~~accommodation desired,insurance coverage, date and type oi treatraent,~~

* Review, list of unoccupied beds and makes preadmission reservations

~~according to the case type and accommodations desired.~~

~~o Ta- * Interviews children and their parents to obtain identifjdn:; and bi~~

~~phical information.~~

~~200 ADMITTING DEPARTMENT~~

~~The adiT.ittin]; department functional flow chart shovís the main activitií~~

~~0 f this department. The acti^vities are as follovjs:~~

* Adj dnistration and overall direction of the auÆÍssion function. * Goordinatin^; of acmissions vdth other hospital functions. * Direct super^vision of admissions acti-vities. * Accepting reservations for aôjaission and scheLulinT future acLTÍssions. * Intervie dng parents to collect the information ne::essary to identify the patient,

~~"^ Kantainin''; a bed index sho-idng the current occupancy status of all patients rooms in order to schedule and assign beds for aLjiissicn and transfer.~~

* Miscellaneous acti-vities such as escorts, dvi'^"^:' o^t information, checking insurance benefits and creating a rslayced horr.e-li.cc atrr.ospliere for the clTÍldren's benefit.

~~201 ADMITTING DEPARTMENT FUNCTIONAL FLOW CHART~~

~~PHYSICIAN REFERREO SELF- INDIVIOUAl. REFERRED INDIVIDUAL~~

~~iliiliriiiiiiiiiiiiz~~

~~NOTE •~~

~~INFORMATION~~

~~HOUTINE PATIENT~~

~~EMERSENCY~~

~~FUNCTIONS 8Y THE ADUITTINe OEPT.~~

~~202 ADMITTING DEPARTMENT WITH ADJACENT MEDICAL DEPARTMENT~~

~~ACCESS CORRIOOR~~

~~COAT ROOM *ND TOILET AL30 8ERVE MEDICAL RECORO PER30NNEL~~

~~20 3 FACILITY NO. 007 DESCRIPTION Admitting Reception NO. OF UNITS Desk Area NO. OF OCCUPANTS l NET AREA ^32 Sg. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~This area functions as a reception and coordinating center for all~~

~~admissions traffic at the adraitting Department, The desk is manned by~~

~~one or more cleaks who receive patients, record their arrivals and assign~~

~~them to the proper interview offices, Follovdng their admission, the clerks~~

~~(2) may also be responsible for coordinating records vdth certain parents.~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~Electrical: Standard~~

~~HVAG: Standard~~

~~Gommurdcations: Standard~~

~~Walls : Standard~~

~~Floor: Standard~~

~~Ceiling: Standard~~

~~FURNITURE/E3UIPMENr:~~

~~1- Transaction Counter~~

~~2- Clerical svdvel chair~~

~~I- Control Counter~~

~~I- Table~~

204 FACILITY NO. 008 DESCRIPTION Admitting Office and Gubicle(s) NO. OF UNITS 1- Admitting Office NO. OF OCCUPANTS ~~ Admitting Cubicles !\- persons NET AREA 200^ Sq^. Ft. (admitting Cubicles) 128 Sq. FL. ( AdiidLLIiig cublcltis) FUNCTIONAL DESCRIPTION The admitting office pro"vide work area for the clerks toperform various functions essential to the acimission and cdsposition of patients. It is assumed that the functions of admitting cubicles are essentially these of admitting the office, OCCUPANCY The admitting office provide indi-vidual v7ork area for admitting officers, to perform various functions essential to the admission and disposition of patients, chairs for two visitors, and space for one person in víheelchair, Each Admitting Cubicle - 1 The Cubicle have space for the admitting officer, chairs for tvro visitors and space for one person in wheelchair, The hypothetical nuraber of out patient "visits in an 100 bed hosoitial armuarlly is of 50,000 "visits. ADJACENT AREAS The adjacent areas are the lounge-vjriting areaj raain outpatient and eraergency service xvaitin,g area, or corridor commurdcating vdth those areas; and Admitting Department work area, ARGHITBGTURAL CONSIDERATIONS. Lighting: Standard Acoustical: Standard E ectrical: Minimum of two IIOV duplex outlets per of.fice or cubicle, HVAC: Standard Communication: Standard Walls: Standard . Gubicle partitions 4'6" dgh and 66" clear vddth betv/een to admit éO" wide desk, and acoustically treated above chair rail. Floor: Standard Geiling: Standard

~~205 FURNITURE/EQUIPMENT: 3- Clerical Desk 3- Unitized "1" Unit 3- Glerical sidvel Chair 6- Straight chairs.~~

~~206 FACILITY NO. 009 DESCRIPTION Admissions Work Area NO. OF UNITS 1 NO. OF OCCUPANTS ^ NET AREA 215 Sn. Pt.~~

FUNCTIONAL DIBCRIPTION This area pro^vides space for routine clerical v7ork and equi"oment necessary to impleraent the admission and cdsposition of patients, such as recei^ving telephone and postal communications; maintaining hos'oital occupancy directories and records, and filing forms vdth other departments.

~~ADJAGENT AREAS For adjacent required areas refer to the Actaitting office and cubicles, both are the same.~~

~~ARGHITBCTURAL CONSIDERATIONS Lighting: Standard Electrical: Standard HVAC: Standard Communications: Standard Walls: Standard floor: Standard~~

~~FURNITURE/ BQUIPMENT: I- Clerical desk 1- Unitized "L unit 2- Clerical swivel chair 2- Standard L- Dravjer file I- Mobile appointment "visible index 1- Patient master index 1- Supply cabinet.~~

~~2C7 FACILITY NO. oio DESCRIPTION MAGHIÎ^IE Roæ NO. OF UNITS I NO. OF OCCUPANTS 3 NET AREA 140 ;>. Ft.~~

FUNCTIONAL DESCRIPTION This area provides space ior developing original patient adrnissions :x-icuiT ent&, inclucdn,-; notification forms anc cards. Daily reports also i'dll be prepared and produced in tlds room, ADJACENT ARKAS The adjacent area is the adrdssion work area. It is advantageous to pro^vLde a passthrough vdndovr from the macldne room to the acimissions work area, so dc)^cum"ênts can be exchanged. • 0 Ctj '^ í ""fS

~~OCCUPANCY The occupancy is one adraission and two cdsposition ; clerks.~~

.ARGHITEGTURAL CONSIDERATIONS Lighting: Standard Accoustical: Standard ELectrical: Standard. Glose attention to rnac dne manuiacture's snccifications is raandatory. HVAG: Standard Floor: Standard Walls: Standard Geiling: Standard Comjnurdcations: Standard, Universal air-tube station.

FURNITURE/BQUIPFIEIff: 2- Auxiliary cabinet for keyboard type. 1- Electrostatic copier and stand 1- Worktable w/kneehole and base cabinet 1- Supply cabinet 2- Clerical svdvel chair I- Lavatory (handvíashing)

~~208 FACILITY NO. oii DESCRIPTION IvT-ieelchair Alcove NO. OF UNITS 1 NO. OF OCCUPANTS 0 NET AREA 25 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION This alcove pro"VÍc.es holding space for wheelchairs or adraittance" chairs for escorting admissions patients.~~

~~OCCUPANCY No perraanent personnel is required for these area.~~

~~ADJACENT AREAS The adjacent areas are the ac'oission vraiting area and main er;ier;en;y entrances, or the lanes of approach to the víaiting area.~~

~~ARGHITECTURAL CONSIDSRATIONS Lighting: Standard Walls: Standard Ceiling: Standard, Mirdmum height 4'0" is required.~~

~~FURNITURE EQUIPMENT: Two admittance chiars with luggage rack and safety brakes.~~

~~209 FACILITY NO. 012 DESCRIPTION Coartroom NO. OF UNITS ^ NO. OF OCCUPANTS ^ NET AREA 42 Sq..?t.~~

~~FUNCTIONAL DESCRIPTION This area pro^vides facilities for adjrdtting and medical record personnel to deposit their wraps, Also provLdes a work sink for medir^al record file clerks .~~

~~OGGUPANCY No permanent personnel is required for tlds area,~~

ADJACENT AREA These area should be adjacent to the aisle or corridor customarily used by most eraployees upon entering or iea^ving the admitting medical record complex and easily accessible to raedical record file clerk area and other vrork areas within the complex.

~~ARCHITBCTURAL CONSIDERATIONS. Lighting: Standard HVAC: Standard Walls: Standard Floor: Standard Ceiling: Standard Electrical: Standard Plurabing: Standard~~

~~210 FACILITY NO. 013 DESCRIPTION Restroom NO. OF UNITS 1 NO. OF OCCUPANTS i NET AREA 30 Sq.^Ft.~~

~~FUNCTIONAL DæCRIPTION This area pro"vddes toilet facilities for female perso"nnel of the admitting-raedical record coraplex.~~

~~ADJACENT AREAS Adjacent to an aisle or connecting corridor vdthin the complex which provides easy access for all personnel on duty.~~

~~ARCHITECTURAL GONSIDERATIONS: Lighting: Standard Electrical: Standard H.V,A.C.: Standard Plumbing: Standard Walls: Geramic tile is nighly recommended FIoo rs: St andard Ceiling: Standard~~

~~FURNITURE/EQUIPMENT : I- toilet fixture I- Lavatory and mirror.~~

~~211 FINANCIAL DEPARTMENT~~

~~# Room Eleraents Net Sq.Ft. Required~~

~~014 Financial Secretarial Rra 132~~

~~015 Business Manager Office 117~~

~~016 Telephone Swithboaid I6O~~

~~017 Cashier Work Area 144~~

~~018 Interview Office 108~~

~~019 General Accounting 305~~

~~020 Accounting Machine 300 1,266 Sq.Ft.~~

~~212 FINANCIAL MANAGEMENT UNIT~~

This unit raanages the hospital 's business acti"vities and keeps the administration informed of its financial condition, More specifically, the following functions are inr-luded: * Receive revenues and expenditures. * Record all financial transactions, inclucdng control of cash and recorcdng of purchase. * Develop payroll records and payment of solaries, * CoIIect unpaid bills, Because it generates hea^vy traffic and many transactions occur, this unit should be conveniently accessible to the general public and to

~~ADM. CORRIDOR~~

~~L SAFE a VAULT 2.C0UNTER~~

~~various hospital departments, but it also deraands prLvacy and isolation, Some of the functions outlined above may be done manually or electronically in the data processing urdt.~~

213 Financial Management Unit and Medical Library Urdt generate extensive traffic and should be located adjacent to the main lcbby, •^Sections requiring privacy and ha"ving little traffic, such as the executive unit and the conference and board meeting unit, should be at the far end of the main lobby with possibly independent egrees to the outside.

~~214 FACILITY NO. 014 DESCRIPTION FLnancial Secretarial Office NO. OF UNITS 1 NO. OF OCCUPANTS 4 NET AREA 132 Sq. Ft.~~

~~FUWCTIONAL DBSCRIPTION This area provides space and facilities for reception and secretarial services to the business Manager and to the Assistant Bussiness Kannager where this position is providec.~~

~~OCCUPANCY The occupants for these office is a Secretary and three visitors.~~

~~ADJACENT AREA (s) The adjacent areas are the Business Manager's of.fice, general accountin- clerical work area, and admirdstrative corridor.~~

ARGHITECTURAL CONSIDE IATIONS: Lighting: Standard Acoustical: Standard ELectrical: Standard HVAC: Standard Comraurdcations: Standard Walls: Standard P oor: Standard. Carpeting is su.ggested. Ceiling: Standard.

~~FURNITURE/BQUIPMEOT : I- Glerical desk 1- urdtized "L" unit 1- Clerical swivel chair 2- Standard 4 drawer file 3- straight chairs~~

~~215 FACILITY NO. 015 DESCRIPTION Business Mana^er's Office NO. OF UNITS j NO. OF OCCUPANTS 4 NET AREA 117 Sg^ Ft.~~

FUNCTIONAL DE3CRIPTI0N The business Manager supervises a"nd directs accounting, crecdt, collection functions, and such admitting functions as may be assi ;:nec., in general is responsible for accounting and financial reports.

~~OGCUPANCY Space allocations are made for the business r.iana^er and three visitors.~~

~~ADJACENT AREAS The adjacent areas are the Secretarial financial office and general accounting clerical víork area,~~

iGGHITBGTURAL CONSID.ERATI0NS Lighting: Standard Acoustical: Standard Electrical: Standard HVAG: Standard Coramunications: Standard Walls: St andard Floor: Standard Celing: Standard FURNITURE/BQUIPME ff I- Manageraent cesk 1- unitized "L" urdt I- management svdvel chair 3- Gonference straight chair 1- Bookcase.

~~216 FACILITY NO. Oi6 DESCRIPTION Iri-i''" rr"ia"rdon anc: Telephone Switc"i-3cs.r' NO. OF UNITS f"'''' NO. OF OCCUPANTS 3 NET AREA i''0 Sg.; ?t,~~

FUNCTIONAL DESCRIPTION Tlds area pro"d:;es information and fulfills comraunication needs of patients and "visitors enterin']; the hospital lobby through the main entrance. Additional acti"vities also include pagin,;^ "los^pital staff members and iraintai- rdng a list oi patients. During periods of little activity, the attendat may help ^dth the maid tyne, and perform other tasks.

~~OCCUPANCY |. Sufficient space is alocated for a telephone console attendat and two information clerks.~~

~~ADJACENT AREAS The adjacent areas are the raain iobby general accounting clerical work area and cashier work area,~~

~~ARCHITEGTURAL CONSIDEARTION Lighting: Standard Acoustical: Standard ELec"brical: Standard HVAC: Standard Coraraurdcations: Standard Walls: Standard Floor: Satandard Ceiling: Standard~~

~~FURNITURE/EQUIPMEMT : I- Clerical desk (and console) I- Unitized "L" Tinit 3- Clerical svdvel chairs 1- Inforraation - control counter~~

~~217 I- Rezay cabinet I- Table 1- Coat closet (built-in) w/ connecting toilet roora. 1- Water closet and enclosure 1- Lavatory and mirror.~~

~~218 FACILITY NO. 017 DESCRIPTION Cashier VJork Area NO. OF UNITS I NO. OF OCCUPANTS 1 NET AREA 1^^ Sq, ?t.~~

FUNCTIONAL DESCRIPTION This area receives advance payments of patient admissions and transacts financial settlgments at the tirae of discharge. It is manner by cne or more cashiers, usually bonded, who in addittion to recei-ving and accounting for mordes may be responsible also for prepare bank deposits, explain billed items, prepare records and reports and balance cash daily against receipts.

~~OCCUPANCY The occupancy is one cashier.~~

~~ADJACENT AREA The adjacent areas are the information and telephone svdtchboard room and general accounting clerical vrork area.~~

ARCHITECTURAL CONSIDERATION Lighting: Standard Acoustincal: Standard Electrical: Standard HVAC: Standard Communications: Standard Walls: Standard Floor: Standard. Garpeting is suggested. Ceiling: Standard. FURNITURE / BQUIPMENT: 1- Cashier counter 2- Standard undercounter pocket unit 1- Clerical Desk I- Urdtized "L" unit 1- Clerical swivel chair 2- Standard 5-drawer file.

~~219 FACILITY NO. 018 DESCRIPTION Interview office NO. OF UNITS 1 NO. OF OCCUPANTS 3 NET AREA 108 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION The function is to accoraraodate patients who prefer paying their hospital bill in private or while seated and for private cdscussion concering the hospital bill.~~

~~OCCUPANCY The occupants will be a cashier, patient, and patient's corapanion.~~

~~ARGHITECTURAL CONSIDERATIONS Lighting: Standard Electrical: Standard HVAC: Standard Coramurdcation: Standard Walls: Standard Floor: Standard. carpeting is suggested Ceiling: Standard~~

~~FURNITURE/BaUIPMEOT: I- Manageraent office 1- Manageraent swivel chair 2- Conference straight chairs.~~

~~220 FACILITY NO. 019 DESCRIPTION General Accounting NO. OF UNITS Clerical Work Area NO. OF OCCUPANTS J NET AREA 305 Sq, Ft.~~

~~FUNCTIONAL DESCRIPTION This work area pro-vides facilities for clerical accounting and related support acti-vities for the financial Manageraent unit. OCCUPANCY The occupancy is four accounting clerks~~

~~ADJACENT AREAS Adjacent area are the inforraation and telephone svdtchboard area, business raanager's office, financial raanageraent secretarial office, and accounting machine room.~~

ARCHITECTURAL CONSIDERATIONS Lighting: Standard Acoustical; Standard Electrical: Standard HVAC: Standard Coraraunications: Standard Walls: Standard Floor: Standard. Carpeting should be used. Ceiling: Standard,

~~FURNITURE/EQUIPMENT : 4- Clerdcal desk 4- Urdtized "L" unit 4- clerical svdvel chairs 5- Standard 4- drawer file 1- supply cabinet 1- Wardrobe unit.~~

~~221 FACILITY NO. 020 DESCRIPTION Accounting Machine Roora NO. OF UNITS I NO. OF OCCUPANTS 1 NET AREA 300 Sg. Ft.~~

FUWCTIONAL DESCRIPTION The function of this area is to perforra irdtial processing of routine financial source data and to produce accumulated data in usable forms in time for effective financial manageraent, It is assuraed sorae that transfering of data to punchcards, card sorting, and holding vdll be the perforraance in this area,

~~OCCUPANCY The occupant is ordy one raachine operator.~~

~~ADJACENT AREAS Adjacent area is the general accounting clerical work area.~~

ARGHITECTURAL CONSIDERATIONS Lighting: Standard Accoustical: Standard Electrical: Standard (see raanufacture's specifications) HVAC: Standard Coraraunicatios: Standard Walls: Standard Floor: Standard Ceiling: Standard

~~FURNITURE/EQUIPMENT: I- Electronic accounting raachine with card reader side unit and forras stand I- Card proof punch 1- Card sorter I- output card punch I- Sorter rack~~

~~222 1- Card punch desk urdt 4- Insulated card files 2- Machine posting tray trucks 1- Worktable 1- Desk 3- Clerdcal svdvel chairs 1- Safe 2- Supply cabinets.~~

~~2?3 NURSING ADMINISTRATION UNIT~~

Nursing administration is the process through which organized nursing fulfiles its purpose and contributes to the archievement of comprehensive health care. The nursing service raust be a cleary define entity vdth sufficient resources to accoraplish its objectives. (refer to nurshing service adrainistration unit cdagram).

~~ADM. CORRIOOR~~

~~224 NURSING SERVICE ADMINISTRATION UNIT~~

~~# ROOM ELEMENTS NET sq..Fr,REQUIRE D~~

~~021 Secretarial & Cleric al Area 287~~

~~022 Director of Nursing 169~~

~~023 Assistant Directors 192~~

~~024 Conference Roora 252~~

~~025 Toilet & Locker 108~~

~~026 Storage 40 1,04 8 Sq.Pt.~~

~~225 FACILITY NO. 021 DESCRIPTION Secretarial and Glerical Work Area NO. OF UNITS 1 NO. OF OCCUPANTS 5 NET AREA 287 Sq-.Ft.~~

FUNCTIONAL DESCRIPTION This area provides administrative secretarial and clerical support for the Nursing Service Administration Urdt, It also pro^vides for initial reception and control of •vdsitors. OCCUPANCY The occupancy is for a secretary, reception secretary, and waiting for three •visitors.

~~ADJACENT AREA The adjacent areas are the Administrative corridor, Director of Nursing, storage room, confernce room, restroom and locker room, and assistant Director's Office.~~

ARGHITECTURAL CONSIDERATIONS Lighting: Standard Accoustical: Standard Electrical: Standard UVAG: Standard Communications: Outlets for interphone per secretarial work position. Walls: Standard Floor: Standard-Carpeting Ceiling: Standard

~~FURNITURE/EQUIPMENT : 2- Clerical Desk 2- Unitized "L" Unit 2- Clerical swivel chair 5- Standard /i-Drawer file 3- Straight chairs.~~

~~226 FACILITY NO. 022 DESCRIPTION Director of Nursing Service Ofiice NO. OF UNITS 1 NO. OF OCCUPANTS 7 NET AREA 169 Sq.^. Ft,~~

FUNCTIONAL DESCRIPTION The Director of Nursing Ser^vice carries ultimate administrative - authority and responsibility in one or more health facilities for nursing services. As a member of the administrative staff, she participates in forraulating hospital policy, in de^vising procedures essential to the achievement of objedtives, and in developing and evaluating programs and ser^vices, She has full authority and responsibility lor the development of nursing servLce policies. The responsibilities of the position are to plan, organize, direct, coordinate, and evaluate activities of nursing service staff. The nature of the position implies accountability for creating a social system which fosters the participation of nursing staff in plannin.;, irapleraenti"ng, and evaluating practices to ensure safe, efficient, and therapeutically effective nursing care. OGGUPANCY The occupancy is the director of nursing service and six "visitors. ADJACENT AREAS Adjacent areas are the secretarial and clerical work area. ARGHITBCTURAL GONSIDERATIONS: Lighting: Standard Acoustical: Standard Electrical: Standard Goraraunications: Standard HVAG: Standard Walls; Standard Floor: Standard Ceiling: Standard

~~FURNITURB/BQUIPMENT : 1- Manageraent desk 1- Unitized "L" Unit~~

~~227 1- Sink w/goose neck spoot~~

~~2- sink laboratory~~

~~I- sterilizer laboratory~~

~~1- cheraical table~~

~~I- raicroscope table~~

~~L- 4 Drawers cabinet filling~~

~~1- Desk office~~

~~2- Incubator iaboratory~~

~~2- Microscope binocular~~

~~2- Microscope raonocular~~

~~1- oven, laboratory~~

~~I- oven, sterilizing~~

~~3- adjustable stool lab.~~

~~1- table 30" X 54"~~

~~228 FACILITY NO. 023 DESCRIPTION Assistant Directors of Nursin^ Service NO. OF UNITS Office. NO. OF OCCUPANTS ^ NET AREA 192 Sq, Ft.~~

FUNCTIONAL DESCRIPTION The Assistant Directors of Nursing Service direct and coordinate administrative and nursing service acti-vities. The Director of nursing ServLce usually has two or more assistan Directors. These include one or more Assistant Directors of Nursing Service for day, everdng, or nights,

~~OCGUPANCY Occupancy are five four Assistant Directors of Nursing Service, and three visitors.~~

~~ADJACENT AREAS The adjacent areas should be the secretarial and clerical work area.~~

ARGHITECTURAL CONSIDERATIONS Lighting: Standard Accoustical: Standard Electrical: Standard Comraurdcation; Standard HVAC: Standard Walls: Standard Floor: Standard- carpeting is suggested. Ceiling: Standard

~~FURNITURB/EQUIPMENT : 2- Manageraent desk 2- Unitized "L" unit 2- Manageraent svdvel chair 3- Gonference straight chair 1- Bookcase 2- Standard 4- Drawer file.~~

~~229 FACILITY NO. 024 DESCRIPTION Gonference Room NO. OF UNITS 1 NO. OF OCCUPANTS 8 NET AREA 252 Sq. Ft.~~

FUNCTIONAL DESCRIPTION This room pro"Vides a limited area for conducting meeting, group discús'sions, and conference invol"vdng the adrairdstrative, educational, and supervisory personnel responsible for the hospital's nursin^ service program. These raeeting are frequent and "vital to an adequate pro,gram of nursing service and nursing education.

~~OCCUPANCY Eight persons would be the maximum occupancy to this area,~~

~~ADJACENT AREA The adjacent area are the Secretarial and clerical work area.~~

ARGHITECTURAL CONSIDERATIONS Lighting: Standard, Rheostat. Accoustical: Standard Electrical: Standard Commurdcation: Standard HVAC: Standard Walls; Standard. Wall paper is suggested Floor: Standard - carpeting is suggested Ceiling: Standard Windows: If provided, to be equipped mth blackout drapes.

~~FURNITURB/BQUIPMENT : 1- Conference table 8- Conference chairs 1- Chalkboard, projection screen.~~

~~230 FACILITY NO. 025 DESCRIPTION Toilet and locker Room NO. OF UNITS 1 NO. OF OCCUPANTS 3 (restroom area) MCT ADPA 3 (dressing area) NET AHtA 108 Sq.^Ft.~~

~~FUNCTIONAL DESCRIPTION Tlds area pro"vides toilet facilities for personnel of the nursing" Service Admirdstration Unit and dressing space for administrative personnel of the unit to put on uniforms.~~

~~OCCUPANCY The occupancy should be three persons for the restroom area and four persons, maxiura for the dressing area.~~

~~ADJACENT AREAS Adjacent Areas are the secretarial and clcrical work area.~~

ARCHITECTURAL CONSIDERATIONS: Lighting: Standard Accoustical: Standard ETLectrical: Standard HVAG: Standard Plumbing: Standard Walls: Geramic tile is suggested. Floor: Geraraic tile is suggested Ceiling: Standard FURNITURE/BQUIPMENT 4- Clothes locker 1- Stool 2- Watercloset 2- Lavatories and rairror.

~~231 FACILITY NO. 026 DESCRIPTION Storage Roora NO. OF UNITS 1 NO. OF OCCUPANTS ^^""^ NET AREA ^" ^"^' ^'~~

~~FUNCTIONAL DESCRIPTION This area pro"vddes storage space for inactive files, includdng secured files, and short-terra inventory office supply,~~

~~OCCUPANCY No pennanent personnel is required,~~

~~ADJACENr AREAS Adjacent areas are the Secretarial and clerical work~~

~~ARGHITECTURAL CONSIDERATION Lighting: Standard Walls: Standard Floor: Standard Ceiling: Standard~~

~~FURNITURE/EQUIPMENT : 1- Secured 4 drawer file 1- Supply cabinet.~~

~~232 EXECUTIVE UNIT~~

~~FUNCTIONAL PROGRAM~~

~~# ROCM ELEMENTS NET SQ.FT.RBQUIRED~~

~~027 Executive Secretarial 216~~

~~028 & Clerical Area~~

~~029 Adrairdstror's Office 208~~

~~030 Assistant Admirdstrator 156~~

~~031 Conference Rra 740~~

~~032 Coatroora 54~~

~~033 Medical Library 254~~

~~034 Micro Room 60~~

~~035 Executive Toilets 72 1,760~~

~~233 EXECUTIVE UNIT~~

~~The executive Unit cdrects all functions of the hospital in keeping~~

~~with overall polices established by the board of Govemors so that~~

~~objetives of patient care service raay be archieved raost effectively.~~

~~The head of the Execiiite urdt is the Hospital Admirdstrator, who is~~

~~also the depoty of the board of govemors. (Refer to Executive Unit Diagram)~~

~~234 Facility No. 027~~

~~Description Executive Secretarial~~

~~And Glerical Area~~

~~No. of Units 1~~

~~No, of Occupants 5~~

~~Net Area 216 Sq.Ft.~~

~~Functional Description~~

~~This area pro"VÍdes space for secretarial and related support for the executive Unit, Occupants cdctate traffic to and from the various executive offices.~~

~~Occupancy~~

~~Sufficient space raustb e allocated for a receptiordst-secretary, clerk- typist, and a writing area for three persons.~~

~~Adjacent Areas~~

~~The adjacent areas are the Hospital Admirdstrator's office and~~

~~Adrairdstrative corridor.~~

~~Architectural Considerations~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~EIectrical:Standard~~

~~235 Commurdcations: Master phone, standard~~

~~UVAC: Standard~~

~~Walls: Standard~~

~~Floor: Standard, Carpeting is suggested~~

~~Ceiling: Standard~~

~~FURNITURE/BQ.UIPMENT :~~

~~2- Glerical Desk~~

~~2- Urdtiled "L" unit~~

~~2- Clerical svdvel chair~~

~~2- Standard 4-drawer file~~

~~3- Conference straight chair.~~

~~236 Facility No. 028~~

~~Description Administror's Office~~

~~No, of Units 1~~

~~No. of Occupants 5~~

~~Net Area 208 Sq, Ft,~~

~~Functional Descrdption~~

~~This area pro"VÍdes space for the hospital Adrainistrator, who directs~~

~~and coordinates all acti"vities of the hospital, His .job corabines one or~~

~~raore of the following: Gontroller/ cdrector of Personnel adrainistration,~~

~~Director of public relations, and purchasing agent.~~

~~Occupancy~~

~~Spa.ce pro"vision for the hospital Adrainistrator and a small conference room~~

~~must be made~~

~~Adjacent Areas~~

~~The Adjacent areas are the executive secretarial and conference room,~~

~~Architectural Considerations~~

~~Lighting; Standard~~

~~Accoustical: Standard~~

~~Electrical: Standard~~

~~237 Gommunication: Standard and a separate private telephone~~

~~HVAC: Standard~~

~~WALLS: Standard~~

~~Floor: Standard, Carpeting is suggested~~

~~Ceiling: Standard~~

~~FURNITURB/BQUIPMENT:~~

~~I-41anagement desk~~

~~I- Manageraent svdvel desk~~

~~4- Lounge Chair~~

~~1- Manageraent cabinet~~

~~I- Periodical Table~~

~~238 Facility No. 029~~

~~Description Assistant Administråtor's Office~~

~~No. of Units I~~

~~No. of Occupants 4~~

~~Net Area I56 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

This area pro"vides space for the assistant administrator, who assists in administration and coordination of hospital acti^vities and recomraends changes in adrainistrative policies. The also overses the operation of various

~~Departments, suggesting new constmction, alteriation of equipment and re"vision of functions.~~

~~Occupancy~~

~~Space pro^vision for the assistant hospital Aciiiinistrator and three •visitors most be made~~

~~ADJACBNT AREAS~~

~~The adjacent areas are the executive secretarial and clerical areas,~~

~~ARCHITECTURAL CONSIDERATIONS:~~

~~Lighting: Standard~~

~~Arrnii?ti?ca: Standard~~

~~EIectricaI;Standard~~

~~239 Gommunication:Standard with outside line,~~

~~HVAL: Standard.~~

~~Walls: Standaro~~

~~FLOOR; Standard, carpeting is su.ggested~~

~~Geiling: Standard~~

~~FURMTURE/BQUIPMEIJT :~~

~~1- Management Desk~~

~~1- Unitiled "L" unit~~

~~I- Management svdvel chair~~

~~3- Lounge chairs~~

~~1- Periocdcal table~~

~~1- Bookcase~~

~~240 Facility No. O3O~~

~~Description Conference and Board Meeting Room~~

~~No of Units I~~

~~No, of Occupants 38~~

~~Net Area 740 Sq,Ft.~~

~~FUNCTIONAL DESCRIPTION~~

This roora vdll accoramodate meetings of board members, Administrative personnel, and sirailar groups within the hospital. If the room is intended to accoramodate all administrative conferences and meetings, it should be equipped with a folding cd"vider partition to permit two small conferences to meet simultaneously.

~~OCCUPANCY~~

~~Space pro"visions for 38 persons should be made,~~

~~ADJACENT AREAS~~

~~Adjacent areas are the storage room, hospital administrator's office, coatroom, and admirdstrative corridor,~~

~~ARCHITECTURAL CONSIDE IATIONS~~

~~Lighting; Standard, dimraer svdtch~~

~~Accoustical; Standard~~

~~Electricai; Standard~~

~~241 Coraraunication: Standard~~

~~Walls: Paneling (optional); ídndows, a pro"vided should be equipped with~~

~~blackout drapes.~~

~~Floor:Standard, carpeting is suggested~~

~~Ceiling; Standard~~

~~FURNITURE/BSUIPMENT~~

~~8 - Segmental folding table~~

~~38- Conference roora~~

~~1 - Checkboard~~

~~I - Projection Screen~~

~~1 - Folding divider partition~~

~~242 Facility No. O3I~~

~~Description Coatroora~~

~~No of Units 1~~

~~No. of occupants None~~

~~Net Area 54 Sq. Ft,~~

~~FUNCTIONAL DESCRIPTION~~

~~This roora pro"vides a place for conferees to deposit their wraps.~~

~~OCCUPANCY~~

~~No permanent personnel will occupy the area~~

~~ADJACENT AREAS~~

~~Adjacent area is the conference room near the entrance from the admirdstrative corridor,~~

~~ARGHITECTURAL CONSIDERATIONS~~

~~Lighting; Standard~~

~~Walls: Standard~~

~~Floor;St andard~~

~~Ceiling: Standard~~

~~243 Facility No, 032~~

~~Description Storage Roora~~

~~No. of Units 1~~

~~No of Occupants None~~

~~New Area 126 Sq. Fb.~~

~~FUNCTIONAL DESCRITPION~~

~~This area provides gpace for audiovisual equipraent and certain~~

~~suppleraentary furrdture and equipment when not in use,~~

~~ADJACENT AREAS~~

~~Adjacent areas are the conferce room and the admirdstrative corridor.~~

~~ARGHITECTURAL GONSIDERATION~~

~~Lighting: Standard~~

~~Accoustical; Standard~~

~~Electrical: Standard, Service connections for refrigeration and heating ele-~~

~~raents of coffee bar urdt.~~

~~Plumbing: Standard~~

~~Walls: Standard~~

~~Floor; Standard~~

~~Ceiling: Standard.~~

~~2tt4 Facility No. 033~~

~~Description Medical Library Unit~~

~~No. of Units 1~~

~~No. of Occupants 10~~

~~Net Area 254 Sq, R,~~

~~FUNCTIONAL DESCRIPTION~~

The area pro^vides space for the di^vision of the raedical library that procures, catalogs, houses, circulates, and cdsplays current recreational and educational material for all hospital personnel, OCCUPANCY Space pro^vision for a librarian and seating for 10 persons raust be raade ADJAGENT AREAS

~~Adjacent areas are the Conference Room, micro-room and admirdstrative corridor,~~

~~ARCHITBCTURAL CONSIDERATIONS:~~

~~Lighting; Standard~~

~~Acoustical: Standard~~

~~EleGtrical; Standard~~

~~Coramurdcation: Standard~~

~~HVAG: Standard~~

~~245 Walls: Standard~~

~~Floor; Standard- carpeting is suggested,~~

~~Ceiling; Standard~~

~~FURNITURE/BQUIPMENT :~~

~~I-Desk & swivel chair~~

~~4- Standard face bookshelves I-shelf list catalog 2-Tables~~

~~8- Straight chairs~~

~~4- Lounge chairs~~

~~1- Bulletin board.~~

~~246 Facility No. 034~~

~~Descidption Micro Room~~

~~No, of Units I~~

~~No. of Occupants 2~~

~~Net Area 60 Sq, Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~This area pro^vddes facilities for readers using the micro-collection.~~

~~OCCUPANCY~~

~~Occupancy limit is a maxiraura of two readers.~~

~~ADJACENT AREAS~~

~~The adjacent areas are the library and conference room,~~

~~ARCHIinTURAL CONSIDERATIONS:~~

~~Lighting; Standard, vdth diraraer switch.~~

~~Accoustical; Standard~~

~~Electrical; Standard~~

~~HVAC: Standard~~

~~Walls: Standard~~

~~Floor; Standard, carpeting is suggested~~

~~Ceiling; Standard~~

~~FURNITURE/BQUIPMENT~~

~~1- Gounter for 2 raicro prLnters~~

~~2- Straight chairs. 247 Facility No. 035~~

~~Description Executive Restroora~~

~~No. of Units 2 (raen & Women)~~

~~No. of occupants 22~~

~~Net Area 36 Sq. R. (women) 36 Sq. Ft. (raen) 72 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~This areas pro^vide space for restroora facilities for personnel of the executive unit and those attending conferences and board meetings.~~

~~ADJACENT AREAS~~

~~Restroora should be adjacent to the admirdstrative corridor with easy access frora the administrative complex.~~

~~ARGHITECTURAL CONSIDERATIONS:~~

~~Lighting; Standard~~

~~Electrical: Standard~~

~~H.V.A.G. Standard~~

~~Plumbing: Standard~~

~~Walls: Standard~~

~~Floor; Standard~~

~~Geiling; Standard~~

~~248 NURSING UNIT~~

~~#_ ROOyi ELEMENTS NET SQ, FT. REQUIRED~~

~~036 Team Center 1,104~~

~~037 Medication 294~~

~~038 Office Spaces 600~~

~~039 Clean utility 600 040 Nourdshraent 300~~

~~041 Conference Rm 600~~

~~042 Waiting 600~~

~~043 Playroom 1,200~~

~~044 1-Bed Room(24) 2,400~~

~~045 2-Bed Roora (38) 7,296~~

~~(Closet private toilets and baths) 4,70i^~~

~~046 Treatraent/examiniation 300~~

~~047 Solariums 1,800~~

~~048 Isolation 576~~

~~049 Nursing Unit 560~~

~~(Stations, v-fork, formula & Toilet) 685~~

~~050 Nurse's lockers 750~~

~~051 Public Toilets 150~~

~~052 Soiled utility 360~~

~~053 Consultatons 240~~

~~054 Bouioment storag<: i 300~~

~~249 # ROOM ELEÎ4ENTS~~

~~055 Strecher/wheelchair 360 056 House staff office 240~~

~~057 Linen storage 480~~

~~058 Janitor's Glo. 150 26,649 Sq. R.~~

~~250 NURSING UNIT~~

~~This diagram has been prepared to help archieved a design that will~~

~~enhance over all effectivencess of the Nursing Unit facility, and one that~~

~~will help help pediatric patients cope with anxieties customarily experien-~~

~~ced by the young patient faced vdth hospitalization. Probably the major dis-~~

~~tinction of the hospital pediatric facility from other hospital facilities~~

steras from the face that pecdatric patients are very much different from adult patients. There are certain physiological and psychological characteristics pertinent to each group, and these characteristics have a pronounced effect

~~251 on logical design of the nursing unit.~~

~~NOTE; Since visual observation is •vdtally important, shower and toilet runs~~

~~Should be positioned in exterior walls rather than walls adjacent to~~

~~the corridor.~~

~~252 Facility No, O36~~

~~Description Nursing Team~~

~~No, of Units 6 @ 184 Sq.Ft. Bach~~

~~No. of occupants 2 net Area IIO4 Sq.Ft.~~

~~FUNGTIONAL DESCRIPTION~~

Space assigned to pro^vide services to patients with direct "visual observation to nurses to patient's rooms, and to pro"vide facilities for charting, and re"vievdng clirdcal records of patients. Work counter should be pro"vided, This §pace also serves as a check point for both patients and •visitors.

~~OGGUPANGY~~

~~Calculated occupancy should be 4 nurses.~~

~~ADJACENT ARBAS~~

~~The nursing team center should be adjacent to the dictation room, the Medication Storage Preparation Unit, and the cleaning utility room.~~

~~ARCHITECTURAL CONSIDERATION~~

~~Lighting: Standard~~

~~Accoustical; Standard~~

~~Electrical; Standard~~

~~HVAC; Standard~~

~~Walls: Standard~~

~~253 Floors: Standard~~

~~Geiling: Standard~~

~~Gomraunication: Pro^vdsions for at least one outside line should be placed,~~

~~intercora is required, and a raaster station of the audio-~~

~~"visual nurse call system,~~

~~FURNITURE/ BQUIPMENT~~

~~1- Counter~~

~~4- Svdvel Chair~~

~~2- Drawer cabinet~~

~~1- Calling systera~~

~~254 Facility No. 037~~

~~Description Medication Storage~~

~~Preparation Urdt.~~

~~No. of Urdts 6 @ 49 Sq. Ft. Each~~

~~No, of Occupants None~~

~~Net Area 294 Sq. Ft.~~

~~FUNCTIONAL DEBCRIPTION~~

~~Space pro"vdded for the storage and preparation of medication. Counter~~

~~space should be pro"Vided. Security is a must,~~

~~ADJACENT AREA~~

~~The urdt should be located to the rear of the Nursing Team Center, v/here~~

~~it vdll be under supervisory control.~~

~~ARCHITECTURAL CONSIDERATION~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Walls: Standard~~

~~Floor: Standard~~

~~Ceiling; Standard~~

~~Plumbing: Hot and cold sterile water supply, Standard.~~

~~FURNITURE/BQUIPMENT~~

~~I- Counter vdth sink 1- Top cabinet FURNITURE/EQUIPMENT~~

~~I-Cabinet wall~~

~~I- Open counter~~

~~Haraper~~

~~1- Glose counter~~

~~2- Sterilizer, pressure, unit.~~

~~256 Facility No. O38~~

~~Description Office Space (supervLsor, social~~

~~worker, chief of pediatrics)~~

~~No, of Units 6 @ 100 Sq. Ft. Each~~

~~No. of Occupants 2~~

~~Net Area 600 Sq, Ft.~~

~~FUNGTIONAL DESCRIPTION~~

~~The purpose of this urdt is to pro'vide office space, at least for the supervisor or head nurse, In addition to the supervisor. The unit may be used by the social worker, and the chief of pecdatrics.~~

~~OCGUPANCY~~

~~The occupancy is of two persons.~~

~~ADJACENT AREAS~~

~~A good location for the office is at the central portion of the nursing urdt. Location is flexible, since this office does not require a close relationship with the control Station,~~

~~ARCHITECTURAL CONSIDERATION~~

~~Lighting: Standard~~

~~ELectrical: St^ndard~~

~~HVAC; Standard~~

~~Communications: Standard~~

~~Walls; Standard~~

~~258 Floor: Standard- Resilient is suggested~~

~~Ceiling: Standard~~

~~FURN TURE/ EQ.UIPMENT~~

~~I-Desk w/svdvel chair~~

~~2- straight chairs~~

~~1-filing cabinet~~

~~1- Posting cabinet~~

~~259 Facility No, 039~~

~~Description Clean Utility Unit~~

~~No, of Units 6 @ 100 Sq. Ft. each~~

~~No, of Occupants 1 Or 2 (non permanent)~~

~~Net Area 600 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~In this space the daily work takes place like pro^\dding, water, ice and to patients, also a storage for jidces, or railk shoiiLd be pro^vided,~~

~~ADJACENT AREA~~

~~The unit should be located to the rar of the nursing team Center.~~

~~ARCHITECTURAL CONSIDERATION:~~

~~Lighting; Standard~~

~~Accoustical; Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Walls: Standard~~

~~Floor: Standard~~

~~Ceiling: Standard~~

~~Plumbing; Standard~~

~~260 Facility No. 040~~

~~Description Nourishment Center~~

~~No. of Units 3 @ 100 Sq. Pt. each~~

~~No, of Occupants 2~~

~~Net Area 300 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Forraula preparation and storage take place vdthin the nourishment~~

~~Prepration Center. Counter and work area raust be provided. The requireraents of preparation can be raet through use of a very sterilized area.~~

~~ARGHITECTURAL CONSIDERATION~~

~~Lighting; Standard~~

~~Accoustical; Standard~~

~~Electrical; Standard~~

~~UVAL; Standard~~

~~Walls; Geramic tile is suggested~~

~~Floor; Standard~~

~~Plumbing; Standard~~

~~Comraunication; Standard~~

~~FURNITURE/BQUIPMENT :~~

~~2- Counter open~~

~~2-Counter close~~

~~2- sink in counter~~

~~261 2- Refrigerator, free standing~~

~~2- Garbage disposal.~~

~~262 Facility No. O4I~~

~~Description Conference Room~~

~~No. of Units 3 @ 200 Sq, Ft, Each~~

~~No. of Occupants I5~~

~~Net Area 600 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

A conference roora should be pro^vided for change-of shift conferences, student conferences in conjunction vdth nursilîg^ and raedical education, in service education, and parent teaching. This roora should be eqidpped with a surface board, projection screen, and classroora chairs. If This room is properly designed it vdll afford great flexibility, The roora should be centrally located but out of the raain, flow of traffic.

~~ARCHITECTURAL SPECIFICATIONS~~

~~Lighting:Standard,vdth rheostat~~

~~Acoustical ; Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Coraraunication: Outlets for intercora and close circuit should be provided.~~

~~Walls: Standard, wall panels are suggested.~~

~~Floor: Standard, carpeting is suggested~~

~~Geiling: Standard.~~

~~263 FURNITURE/B3UIPMENT:~~

~~1- Conference table (60" X 48")~~

~~15- Straight Chairs~~

~~1- Projection Screen~~

~~264 Facility No. 042~~

~~Description Wating Room~~

~~No. of Units 3 @ 200 Sq, Pt, Each~~

~~No, of Occupants 14~~

~~Net Area 600 Sq, Ft.~~

~~FUNCTIONAL DESCRIPTION~~

Assigned area to pro^vide sitting facilities for indi^viduals waiting for news about health status of family merabers, An altemat use of the writing roora is for admitting patients cdrectly to the urdt vdthout their going through administration. This room can also be utilized as a cosultation area for the entire family or for gi"vdng special instructions to parents orior to patients discharge. Proper location should be close or adjacent to doctor's office.

~~ARGHITECTURAL CONSIDERATION~~

~~Lighting: Standard~~

~~Ac cousti c al:St andard~~

~~Electrical: Standard~~

~~Goraraunication: Standard~~

~~HVAG: Standard~~

~~Walls; Standard. Pattern wall coverings and drapery fabrics must be chosen carefully.~~

~~265 Floor: Standard, carpeting is suggested,~~

~~Ceiling: Standard~~

~~FURNITURB / BQUIPMENT;~~

~~Ghairs, closet seating, di"vided into sectional, shell type, and lounge seatting.tables, coffee, sectional, and round.~~

~~256 Facility No. 043~~

~~Descrdption Playroom~~

~~No. of Units 3 @ 400 Sq. Ft. Each~~

~~No of Occupants~~

~~New Area 1200 Sq. Pt.~~

~~FUNGTIONAL DESCRIPTION~~

~~The playroom or activity room is a vital part of the pediatric nursing~~

~~urdt. Most raodem playrooms. Affords great flexibility. Meals may be served~~

~~in the playroom area. The olayroom may be used for educational programs and~~

~~both orgardzed and free recreation. Locating the playroom next to a consul-~~

~~tation room vdth one-way window pro"vides opportunity for raedical observa-~~

~~tion, it should also be adjacent or opposite to the control center perraits~~

~~maciraal "visual observation and surveillance. The playroora should have built-~~

~~in toy storage space and a equipraent storage closet. The playroom is an~~

~~Apprôpiate locatidn' foY shovdng educational or recreational programs.~~

~~ARGHITECTURAL SPECIFICATIONS~~

~~Lighting: Standard~~

~~Accoustical: Standard, NOTE: Proper sound proofing of the olayroom is~~

~~essential,~~

~~En.ectrical: Standard~~

~~Gommunication: Outlets for closed-circuit~~

~~Tele'vision and rausic systera is essential~~

~~267 HVAC: Standard~~

~~Walls: Standard. Pattern wall coverings and drapery fabrics must be chosen carefully.~~

~~Floor: Standard. Carpeting is suggested~~

~~Geiling: Standard~~

~~FURNITURB/EQUIPMENT:~~

~~2- Work table bench type~~

~~1- counter W/Sink~~

~~I-Top counter~~

~~Shelves~~

~~I- Lounge furrdture for children.~~

~~268 Facility No. 044~~

~~Description Patient Roora (private)~~

~~No. of Urdts 24 @ 100 Sw. Ft. Each~~

~~No, of Occupants 1~~

~~Net Area 2400 Sq. Pt.~~

~~FUNCTIONAL DESCRIPTION~~

The urdt must pro"vide maximum flexibility, all patients room (private) should be of similar design. All rooms must be capable of being fumished with crdbs or twin. Size bed. Bach bedroom shoiiLd be adjacent to a restroom facility wardro'be cabinets, and hand washing sink. Ideally, every restroom should also have a tub/shower urdt.

There should be liberal use of observation vdndows in the corridor wall of all patients rooms, These windows assist the nursing staff and reduce the feeling of isolation of the bedfast child, These unit must be adapted to the environraent to the child's scale by alterdng a few critical dimensions, such as the windows sill, and the distance of svdtches.

~~OCCUPANCY~~

~~Hospital building codes requires 80 Sq. Pt. per patient, the extkunits' space are for parent's accomodation.~~

~~ADJACENT AREAS.~~

~~The adjacent areas are the restroom, wardrobe cabinet and the nurses's station.~~

~~269 ARCHITECTURAL CONSIDERATIONS~~

~~Lighting; Standard, provide a dimraer switch. Natural lighting is essential, Acoustical: Standard,~~

~~Electrical: Standard, but they raust be eliminated or coverved from crawling area,~~

~~HVAC: Standard~~

~~Plumbing: Standard , Vacuum and oxygen outlets should be provided for each bed,~~

~~Commurdcations: Telephone and nurse calling outlets should be provLded for each bed, t,v. jacl.~~

~~Walls: Standard, Patterned, texture materials are suggested,~~

~~Floor: Standard~~

~~Ceiling; Standard~~

FURNITURE/EQUIPMENT: Refer to isolation suite. Note: Allow infants. to xvatch cdfferent types of acti"vdty - nurses at work, children at play, trees outside the vdndow, Staff shoiild be allowed to select colorful pattemed and textured clothing.Open Unit, Rectangular or Square is the configuration most desirable for pediatric nursing urdts due to abundance of open space a"vialable for flexibility of design requirements.

~~270 Facility No, 045~~

~~Description Patient Room (semi-private)~~

~~No. of Units 38 @ 192 Sw. Pt. Each~~

~~No. of Occupants 2~~

~~Net Area 7296 Sw. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

A typical serai-private roora has the sarae characteristic as a private room vdth the exeption that such a room is large enough for two beds. But it is not so iarge as to impose prononunced losses when used for single occupancy or isolation, Some rooms should be di"vided by partitions in between so that they can be served as a four bedroom unit.

~~OCCUPANCY.~~

~~A semiprivate pediatric room should be for 2 patients.~~

~~ADJACENT AREA~~

~~Adjacent areas are the restroom, wardrobe cabinet and the nurse's station,~~

~~ARCHITBCTURAL CONSIDERATION~~

~~Same as the prdvate room.~~

~~271 Facility No. O46~~

~~Description Treatment/Examination Room~~

~~No, of Units 3 @ 100 Sq, Ft Bach~~

~~No. of Occupants 4~~

~~Net Area 300 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

In this space doctors and nurses examine and pro"vide treatment to infants bathing raaytak e place in this space. Should be located so as to doctors need not to enter nurseries. Counter space is needed.

~~ARCHITBCTURAL SPECIFICATION~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~Electrical: Standard, be provided~~

~~HVAG: Standard~~

~~Walls: Standard~~

~~Floor: Standard~~

~~Cetling: Standdard~~

~~Plurabing:Water supply and drainage lines should be provided at work counter.~~

~~FURNITURE/BQUIPMENT;~~

~~I-Bullentin board~~

~~I-Cabinet wall~~

~~272 Facility No. 047~~

~~Description Nursing Urdt solariums~~

~~No. of Units 6 @ 300 Sw.ft. each~~

~~No, of Occupants Varies~~

~~Net Area 1800 Sw, Ft,~~

~~FUNCTIONAL DESCRIPTION~~

Roora pro"VÍdes the child with sun exposure, In raost cases it is located at end of corridor in a nursing unit. It should be arranged so as to be aucdlable for use as bed space in eraergency situations. Large vdndow area should be pro"VÍded.

~~ARGHITBCTURAL SPECIFICATIONS~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~Electrical: Duplex outlet should be pro-vided,~~

~~HVAC; Standard~~

~~Walls: Standard~~

~~Floor; Standard, Carpeting is suggested.~~

~~Ceiling: Standard.~~

~~273 Facility No. 048~~

~~Description Isolation Rooras~~

~~No. of Units I (4 Beds @ ILh sq.ft. per bed)~~

~~No. of Occupants 4~~

~~Net Area l6 Sw, R.~~

~~FUNCTIONAL DESCRIPTION~~

~~Roora pro"vided for children requiring isolation because of infection,~~

Bntrance from corridor shall be pro^vided for nursing observation of potient from nursing station. Private torcet room containing water closet and bathtub or shower shall be pro'vdded. 3est location is at end of corridor.

~~ARGHITBCTURAL SPECICATION~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~Electrical; Standard~~

~~HVAG; Standard.~~

~~Plumbing: Water supply lines and drainage lines should be provided for toilet vacuun and suction supply outlets near bed.~~

~~Walls; Standard~~

~~Floor: Standard. Carpeting is surgested~~

~~Ceiling: Standard.~~

~~274 FURNITURE/ BQUIPMENT:~~

~~1-Bed (adjustable 36" X 78")~~

~~I- Bed side table~~

~~I- Sofa/ lounge~~

~~1- Cork board~~

~~1- Chair straight~~

*SheIves for personal belongings

* Calling system.

~~275 Facility No. 049~~

~~Description Infants Nurshing Units~~

~~No of Units 1 (14 cribs @ 40 sw. ft. per cnb)~~

~~No. of occupants 14~~

~~Net area 560 Sq.Pt.~~

~~FUMCTIONAL DEBCRIPTION~~

~~Nursery unit assi.gned to pro^vide health care ser"vice to infants ranging~~

~~from to 3 years old, Each nursing unit shold contain no more than 4 cribs.~~

~~Each unit shall contain glazed "vLewing vdndows work room.~~

~~FUNGTIONAL REQUIREMEI\1TS~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~Electrical: Standard~~

~~HVAG: Standard~~

~~Gommunication: Standard~~

~~Walls; Standard.~~

~~Floor: Standard. Carpeting is suggested,~~

~~Celling: Standard~~

~~FURNITURE/BQUIPMBNT~~

~~1- Lavotory with gooseneck soout knee or elbow control, bassinet.~~

~~4- side tables~~

~~276 2- incubators~~

~~2- Table, 16 X 20 w/railings~~

~~2- raovable chairs~~

~~12- cribs~~

~~2- rocki"ng chairs~~

~~6- high chairs.~~

~~277 Facility No. O5O~~

~~Description Nurses' Locker and Lounge~~

~~No. of Urdts 3 @ 250 Sw.Ft. Each~~

~~No. of Occupants 6~~

~~Net Area 750 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space pro"vdded for rest and changing clothes before and after shifts.~~

~~Locker room shoiild be separate but converdent to lounge. Locker rooms shall be pro"vdded with restroom facilities area should be arrange to pro"vide confortable, relaxijlg^ atmosphere.~~

~~ADJACENT AREA~~

~~This area should be centraly located, adjacent to the Adrairdstrative~~

~~Control Station,~~

~~ARGHITBCTURAL CONSIDERATION~~

~~Lighting; Standard~~

~~Accoustical: Standard~~

~~Electrical: Standard~~

~~HVAG: Standard~~

~~Coraraunication: Standard~~

~~Wall; Standard~~

~~278 Floor: Standard, Carpeting for the lounge area is suggested.~~

~~Ceiling: Standard,~~

~~FURNITURE/EQUIPMENT~~

~~Standard, refer to nursing unit.~~

~~279 Facility No. 05I~~

~~Description Public restrooras~~

~~No. of Units 3 @ 50 Sq.Ft, Each~~

~~No, of occupants 1~~

~~Net Area I5O Sq.Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~This area pro"vddes restroora facilities for mothers and fathers, and other •vdsitors,~~

~~ADJACEÎW AREA,~~

~~It should be adjacent to the writing area and main corridor.~~

~~ARGHITECTURAL CONSIDERATION~~

~~Lighting: Standard~~

~~Electrical: Standard~~

~~HVAC; Standard~~

~~Plumbing; Standard~~

~~Walls; Ceramic tile is suggested.~~

~~Flo 0 rs: Standard,~~

~~Ceiling: Standard,~~

~~280 Facility No. O52~~

~~Description Soiled Utility~~

~~No. of Units 6 @ 60 Sq.Ft. Each~~

~~No. of Occupants Varies~~

~~Net Area 360 Sq. Ft,~~

~~FUNGTIONAL DESCRIPTION~~

~~Víhen the waste bags from the pediatric urdt are full, they are wheeled~~

~~to the soiled holding room and kept there for ultimate pick up by howe-~~

~~keeping personnel, The soiled holddng room also serves other utilitarian~~

~~task, such as equipment víashing and clean up. A service sink and bed pan~~

~~sardtizer should be located in the soiled utility room,~~

~~FUNCTIONAL REQUIREI4EMTS~~

~~Lighting: Standard~~

~~Electrical: Standard~~

~~Walls: Cerainic tile is suggested~~

~~Floor: Ceramic tile is suggested~~

~~Plumbing: Standard,~~

~~281 Facility No, 054~~

~~Description Equipraent Storage~~

~~No. of Units 3 @ 100 Sq Ft. Each~~

~~No, of Occupants None~~

~~Net Area 300 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~This area pro"vddes stora,ge space for eq-uipraent, including files office supply and space for parking beds.~~

~~ARGILETECTURAL CONSIDERATIONS~~

~~Lighting; Standard~~

~~Walls: St andard~~

~~Floor: Standard~~

~~Ceiling: Standard~~

~~282 Facility No, O55~~

~~Description Strecher and Víheelchair Storage~~

~~No, of Units 3 @ 320 Sq, Ft, Each~~

~~No. of Occupants None~~

~~Net Area 360 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~This alcove pro'vides holding space for wheel chair for escorting patients.~~

~~ARGHITECTURAL GONSIDERATIONS~~

~~Floor: Standard~~

~~Gelling: Miniraum Height 4'-0"~~

~~283 Eacility No. O56~~

~~Description House Staff Office~~

~~No. of Units 3 @ 80 So. Ft, each~~

~~No, of occupants 2~~

~~Net area 240 Sq. Pt. C FUNCTIONAL DESCRIPTION~~

~~Space pro"vided for the coordination for indi"vidual working as the staff raembers of the hospital. The office should be accesible to the main corridor.~~

~~ARGHITECTURAL SPEGIFICATIONS~~

~~Lightingj Standard~~

~~Acustical: Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Commurdcations; Standard~~

~~Walls: Standard~~

~~Floor: Standard, carpeting is suggested~~

~~Ceiling: Standard,~~

~~284 Facility No. O57~~

~~Description Linen Storage~~

~~No, of Occupants Varies~~

~~Net Area 480 Sq, Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~This space is utilized for the storage and distrdbution of hospital's~~

~~linen, If the cart system is used, the net area should be reduced, In the~~

~~cart system the carts are customarily placed in small alloved along. corridors,~~

~~If the storage room systera is utilized adequate built-in case vrork and~~

~~cabinetry should be pro"vided,~~

~~ARGHITBCTURAL CONSIDERATIONS~~

~~Lighting: Standard~~

~~Electrical: Standard~~

~~Walls: Standard~~

~~Floor: Standard~~

~~Ceiling; Standard~~

~~285 Facility No. O58~~

~~Description Doctors Gonsultations Roora w/toilet~~

~~No. of Urdts 3 @ 80 Sq Ft. Bach~~

~~No of Occupants 2~~

~~Net Area 240 Sq. Pt.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space services the needs of physcians, parents, and patients during consultations it should be provided in a central location.~~

~~ARGHITBCTURAL CONSIDERATION~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Gommurdcations; Outlets for private telephone and intercora.~~

~~Walls: St andard~~

~~Floor; Standard, carpeting is suggested.~~

~~Ceiling: Standard~~

~~Plumbing: Standard~~

~~FURNITURE /EQUIPMENT~~

~~Typical of office furniture.~~

~~286 INTENSIVE CARE UNIT~~

~~ROOM ELJ Ein' NET SQ. FT. REGUIRED~~

~~\ 059 Nursing Station 160~~

~~060 Scrub and govm 50~~

~~061 Medication Preparation 50~~

~~062 Physician Charting & Dictation 60~~

~~063 Conference Rra 250~~

~~064 Clean Supply 130 0 065 Soiled Supply 80 066 Equipraent Storage 120~~

~~067 Treatment Rm 130~~

~~068 Waiting/quiet Rm 280~~

~~069 Patient Toilet 25~~

~~070 6=Bed room 720~~

~~071 Isolation Room (2) 316~~

~~1,311~~

~~287 INTENSIVE CARE UNIT~~

A .great deal of thought and planning should take place before constmction of the Pecdatric intensive care urdt, For flexibility of use and conservation of nursing tacent and equipment, the ixrdt should

~~serve children of all age groups,~~

~~All beds should encircle the nurses station for the reasons of~~

~~•visual or super^vdsion to the child, Isolation roora-should also pro-~~

~~•vided •viauality to .the nurses' station (Refer to cdagram for illustration~~

~~of possible layout).~~

~~288 Facility No. O57 Description Nursing Station No. of Units 1 No. of Occupants 6 Net Area I6O Sq. Pt.~~

~~FUNCTIONAL DESCRIPTION~~

This space is pro^vided for a group of nurses who constantly are monitoring intensive care patient's •vital si,gn. Space also serves as a víork station for filing charts and records, Station should be located as to permit onobstructive direct •visual observation of each patient.

~~ARGHITECTURAL GONSIDERATION Lighting: Standard Acoustical: Standard Communication: Standard HVAG; Standard Walls; St andard Geiling; Standard~~

~~FURNITURE/BQUIPMEOT Typical of nursing station.~~

~~289 Facility No. 060~~

~~Description Scrub and Govm~~

~~No. of Units 1~~

~~No. of Occupants 2~~

~~Net Area 50 Sq. ?t.~~

~~FUNCTIONAL DESCRIPTION~~

Space assigned to pro-vide attending staff vdth washing and cdsinfecting facilities before perforraing surgical interventions. Should be located near entrance to the intensive care Urdt, A scrub sink should be pro-vided.

~~ARGHITECTURAL CONSIDERATION~~

~~Li,ghting; Standard~~

~~HVAC; Standard~~

~~Walls; Standard, Sraooth finish required.~~

~~Floor: Standard. Sraooth finish is required conductive flooring systera is required.~~

~~Ceiling: Standard~~

~~Plurabing: St andard~~

290 Footnotes 1.) G.W. Betsford, Ph. D,, Ancient History, ( New York, I956) , P. 49. 2.) The Encyclopedia Araericana, ( m^ York,1909) Vol. I4, p. 427. 3.) I b i d, p. 438. 4.) Design and Constmction of General Hospitals, (New York , 1953). pix. 5.) The planning and design Process, Maryland, 1977. p. 94. 6.) El Paso Area Fact Book , El Paso Texas, p. I of 10 Section I . 7.) I b i d , p, 5 of 26 Section X. 8.) Southwest Business and Econoraic Review EI Paso, Texas. May I9SO Vol. 4 p, 20-25. 9.) The E3. Paso .Economic Re'vievj'. June 1976, vol. 6 page I5 - 16. 10.) Administrative Services and facilities for Hospitals. U.S. Govern- ment, Washington, D,C. p. 2. 11.) Pena M. Williams, Caudill William, Focke W, John Problem Seeking: An Architectural Programraing Primer. Cahners Books International Inc, 1977. 12.) Palmer A, Mickey, The Architect's Guide to Facility Programming . The American Institute of Architects , 1981, p. 206. 13.) Ibid., 206. 14,) Time Spuer Standard , 5th, Edition, Mc, Graw 1974 , p. 993. 15.) I bid., p, StiS. 16.) I bid., P. 994. 17,) Planning and design for perinatal and pediatric facilities. Ohio 1977 p, 86, 18.) Ibid,, p, 86,

366 30), William J, Mc Gidness, Benjamin Stein and John S. Reynolds, Mechardcal And Electrical Equipme.nt For Builcing, 6th Edition, John Wiley and Sons. New York, 19'G0, 31), Enrique Yanez, Hospitales De Segijiridad Social. Mexico, 1973. 32). Ghanging Hospital En'vironments for Children, Massachusetts, 1972, p, 5^.

~~367~~

~~Facility No. 06l~~

~~Description Medication Preparations~~

~~No. of Units 1~~

~~No. of Occupants 1~~

~~Net Area 50 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space pro"Vided for the preparations of medications, Water sterilizers~~

~~should be pro^vided with counter space,~~

~~ARGHITECTURAL CONSIDERATIONS~~

~~Lighting: Standard~~

~~Acoustical; Standard~~

~~Electrical: Standard~~

~~HVAC; Standard~~

~~Walls; Standard sraooth firdsh is reqidred~~

~~Floor; Standård sraooth firdsh is required~~

~~Ceiling; Standard sraooth firdsh is required~~

~~Plurabing; Hot and cold sterile water supply, standard.~~

~~FURNITURE/BQUIPMENT~~

~~Typical of raedication prepar"ktion.~~

~~291 Facility No. 062~~

~~Description Physician Charting & Dictation~~

~~No. of Units 1~~

~~No, of Occupants 3~~

~~Net Area 60~~

~~FUNCTIONAL DESCRIPTION~~

~~This area is used for dictatin,g charting, raedication preparation.~~

~~Gounter space should~~

~~ARGHITECTUAL CONSIDERATIONS~~

~~Lighting; Standard~~

~~Acoustical; Standard~~

~~HVAG: Standard~~

~~Walls; Standard~~

~~Floor: Standard~~

~~Ceiling: Standard~~

~~FURNITURE/BQUIPMENT~~

~~Typical.~~

~~292 Facility No, 063~~

~~Description Conference Room~~

~~No. of Urdts 1~~

~~No. of Occupants Varies~~

~~Net Area 250 Sq. Ft.~~

~~FUWCTIONAL DESCRIPTION~~

A conference room ídll pro^vdde a meeting place for conferances between the intensive care staff. This roora should be eqidpped vdth surface boardj projection roora, and chairs. This roora sho^dd be located at the entrance of the intensive Care Urdt.

~~ARCHITECTUAL CONSIDERATION~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~Electrdcal: Standard~~

~~HVAC: Standard~~

~~Commurdcation; Outlets for intercora and telephone should be pro^vided.~~

~~FURNITURE/BQUIPMENT~~

~~Typical~~

~~293 Facility No. O64~~

~~DescrLption Clean Supply~~

~~No. of Units 1~~

~~No. of Occupants 2~~

~~Net Area I30 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space assigned for the assembly of clean materials used within the~~

~~Unit. Should be located to all intensive care unit. Should contain~~

~~counter with sink and space and sterile storage.~~

~~ARGHITBCTURAL CONSIDERATIONS~~

~~Lighting; Standard~~

~~Accoustical: Standard~~

~~ELectrical; Standard~~

~~HVAC: Standard~~

~~Walls; Standard. Sraooth firdsh is required~~

~~Floor: Standard, Sraooth firdsh is required~~

~~Ceiling: Standard; Sraooth firdsh is req-uired,~~

~~Plumbing: Oxygen and suction supply outlets should be provided, also water supply and drainage lines should be provided.~~

~~294 Facility No, O65~~

~~Description Soiled Supply~~

~~No,of Units 1~~

~~No, of Occupants 2~~

~~Net Area 80 Sq, Pt.~~

~~FUNCTIONAL DESCRIPTION~~

~~The soiled supply room in addition to holding trash, can also be used for equipraent washing and clean-up, and mostly cleaning of instruments prdor to delivery to central supply for recycling,~~

~~FUNCTIONAL REQUIREMENrS~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~HVAC: Standard~~

~~Walls: Standard, Smooth firdsh is required~~

~~Floor; Standard. Smooth firdsh is required~~

~~Ceiling: Standard, Smooth finish is required.~~

~~Plumbing: Standard.~~

~~295 Facility No. 066~~

~~Description Equipment Storage~~

~~No. of Urdts 1~~

~~No. of Occupants 2~~

~~Net Area 120 Sq. Pt.~~

~~FUNCTIONAL DESCRIPTION~~

~~Equipment storage is extremely important, because there is so many~~

~~equipraent needed in the Unit Care Systera, Equipraent such as wagons, strechers and wheelchairs. This storage should be located vdth in the~~

~~Urdt in itself.~~

~~ARGHITECURAL CONSIDERATION~~

~~Lighting: Standard~~

~~HVAC: Standard~~

~~Walls: Standard~~

~~Floor: Standard~~

~~Ceiling; Standard~~

~~296 Facility No. O67~~

~~Description Treatment Room~~

~~No, of Units 1~~

~~No, of Occupants 4~~

~~Net Area I30 Sq. Ft.~~

FUNCTIONAL DESCRIPTION In this space doctors and nurses examine and pro^vide treatment to children or infants. Infant bathing may take place in this space. Counter space should be provided. Should be located so as doctors need not to leave the urdt.

ARCHITBCTURAL CONSIDERATION Lighting: Standard Accoustical: Standard Electrical: Standard HVAG: Standard Walls: Standard Sraooth finish is required Floor: Standard smooth finish is required Ceiling: Standard Smooth finish is required Plumbing: Standard

~~297 Facility No. 068~~

~~Description Víaiting Room & Quiet Room No. of Urdts 1 No. of Occupants IL Net Area 280 Sq. Ft.~~

~~FUNCTIONAL DESGRIPTION~~

Assigned area to pro^vide sitting facilities for indi^vdduals víaiting for news about health status of family members or relatives vího are in the intensive care urdt. Room should reflect a warm, tranquil atmosphere. Located convenient to the Intensive Care Unit.

~~ARCHITBCTURAL CONSIDERATIONS~~

Lighting: Standard Accoustical: Standard Electrical: Standard UVAC: Standard Comraunications: Telephone outlets should be provided for orivate telephone. Walls: St andard Floor; Standard, carpeting is sug,gested. Ceiling: Standard,

~~298 Facility No. O69 Description Patient Toilet No. of Units 1 No. of Occupants I Net Area 25~~

~~FUNCTIONAL DESCRIPTION This area pro'vddes restroora facilities for patients in the Intensive Gare Urdt Only,~~

~~ARGHITBCTURAL CONSIDERATION Lighting: St andard ELectrical: Standard HVAC: Standard Walls: Standard Ceramic tile is suggested Floor: Standard carpeting is suggested Ceilings: Standard~~

~~FURNITURE/BQUIPMENT: Typical~~

~~299 Facility No. O7O Description 6-3ed Roora No. of Units I No. of Occupants 6 Net Area 720 Sq. Pt.~~

FUNCTIONAL DESCRIPTION The purpose of this roora is to pro^vdde hi,gh quality and soecialized nursing care for patients vího require very detailed and constant observation Windoiís in the ixnit are reouired so that each patient is aware of the outdoor en"vdronment. Should be locatea conveniently to servLce and circulation corridors.

FUIMCTIONAL RBQUIREÎ'íENTS Lighting: Standard Acoustical: Standard Electrical: Standard HVAC: Standard Goramunications: Outlets for nurse calling system and mcnitoring system should be pro"vdded. Plumbing: Water supply and drainage lines hould be orovided for all beds. Oxygen and vacuum lines shculd be prcvideo in vralls, Walls: Standard. Smooth finish is required Floor: Standard, Smooth finish is required Ceiling: Standard

~~FURNITURE/EQUIPMEIÍT : Typical~~

~~300 Facility No. O71 Description Bed Isolation Room w/Toilet No. of Units 2 @ 158 Sq, Ft. each No. of Occupants 1 Net Area 3I6 Sq. Ft,~~

FUNCTIONAL DESGRIPTION This room provLdes exclusive care for patients requiring soecial treatment a vievdng panel shall be provLded for nursing observation. Best location is at each side of the Intensive Care Unit.

ARGHITECTURAL SPEGIFIGATION Lighting: Standard Acoustical: Standard Electrical: Standard HVAG; Standard Plumbing: Standard, Vacumrn and suction supoly outlets should be pro"vided near bed. Coramurdcation: Standard Walls: St andarcl Floor: Standard. Carpeting is suggested. Ceiling: Standard

~~FURMTURE/BQUIPMENT : Typical~~

~~301 SURGICAL UNIT~~

~~"£ Room Elements Net Sq.Ft, Required~~

~~072 Major operating Room (6) 576~~

~~Minor operating Room 265~~

~~073 Recovery Room 880~~

~~074 Scmb Area 185~~

~~075 Waiting Room 200~~

~~0'6 Supervdsor's Office 100~~

~~0"78 Clean Work Room 30~~

~~079 Darkroom 100~~

~~080 Anesthesist's Room 150~~

~~081 Substerlizin - Room 245~~

~~082 Surgical Doctor's Lounge 340~~

~~083 Surgical Nurse's Lounge 300~~

~~Public Toilet 50~~

~~302 SURGICAL SUiTE~~

~~There are three general ajjreoínents that must be met in order to~~

~~determine the iun::tional relaticns'rdi^ís betvjee"n the roon of the sur.'gical~~

~~suite. Eirst, the need to minimize the introduction of inflection inbc the~~

~~suite from outside, Second, the surgical suite consists of tv.ro areas -~~

~~one accesible only to personnel in lean scmb clotid-n,": and the other acce-~~

~~ssible to oersons vdthout restrictions as to clot:dn . Third, the entr:,^ into~~

~~the suite should be controlled at all times.~~

~~303 FACILITY NO. 072 DESCRIPTION I' a.lor Oi"")oratin"'; Room NO OF UNITS 2 @ 288 Sq, 7t, Eacn NO. OF OCCUPANTS . i,w. V w ^ pg^ room NET AREA 576 So. Ft.~~

FUNCTIONAL DESCRIPTION Space assi.gned for the practice of major sur;^ical interventions, bei"n- those wld-ch requires a high de~ree of asepsis and a vdde range of instruments and equipment. The operating room should be placed in a"" restricted area. It should also be convenient locatecl to the emerge-ncy pathology. Minimum dimension should be l6"-0" X 18'-0"

ARCHITBGTURAL CONSIDERATION Lighting: Standarc. Supplementary should be pro^vdded by ceilin^ mo.unted movable fixtures, Acoustical: Standard. Electrical: Standard. An adcdtional receptacle should be provided and marked fox x-ray use all wall outlets should be located 5'-0" above floor. Walls; Standard, Smooth Firdsh required Floor: Standard Sraooth Finish Required Ceiling: Standard Smooth Finish Required

FURNITURE/BQUIPI"ÎENT : 4- Calling Stations 4- Illuminator, film vapor proof 12- Shel-ving adjustable 4- Anesthesia appara^bus 4- Electro surgical urdt Ô- Kick bucket 4- Haraper chute 4- Stand irrigator 4- Stand solution, double basin 4- Stand solution, single basin

~~304 8- Stool adjustable 12- Stool foot 4- Suction Apparatus 4- Anesthesia table L- Instrument table (24" livB") 4- Intrument table, mayo 4- Operating table 4- Light eraergency, portable~~

~~305 FACILITY NO. 073 DESCRIPTION Surgery Recovery Roora NO. OF UNITS , ( 3^,^) NO. OF OCCUPANTS 5 NET AREA 880 Sg. R.~~

FUNCTIONAL DESGRIPTION A space assigned to pro^vdde a high standard of nursing care durdng'the recovery period, as well as pro"vdding prorapt attention in an emergency. This room is not like the intensive care urdt, This space may be located inlDetween general nursing units and surgical suite. Privacy screens should be pro"vdded between beds. ARCHITECTIÍRAL CONSIDERATION Lighting: Standard Acoustical: Standard Electrical: Standard HVAC: Standard. Coramurdcation; Outlets for nurse calling system should be orovidecl per bed. Plumbing: Oxygen and suction supply outlets per bed. HVAC: Standard Comraurdcations: Einergency commurdcations system should be provided, Plumbing Standard, Additional oxygen, suction outlets be provLded. Wall; Standard smooth finish is required s Floor: Standard, Smooth firdsh is required, Geiling: Standard, Smooth I^nish is required, FURNITURB/BQUIPI#]OT : I-Bulletin Board 26" X 24" 2- Lavatory, elbow or knee control 1- Holder, chart & desk 2- Light examirdng 1- Table instruments I6" X 20" 1-Table office 24" X 36" 5- Recovery Beds 5- Table beds.

~~306 1- Garbage disposal 1- Exaraination table w/stool~~

~~I-work table~~

~~I- Counter w/sink~~

~~1- Refrigerator 6cu ft,~~

~~2- Sterilizer, electric instruraent.~~

~~307 FACILITY NO. 074 DESCRIPTION Sur'^dcal Scmb-up Area NO. OF UNITS I NO. OF OCCUPANTS 4 NET AREA 185 Sg. Ft,~~

FUNCTIONAL DESCRIPTION Space assigned to pro"vdded and attencdng surgical staff vdth víashing and cdsenfecting facilities before perforraing surgical interventions, Should be located near entrance to each operating rooras. Vievdng vdndovf into surgery room should be provided to allov'j" surgeons to observation of surgical prepartions,

ARGHITECTURAL SPECIFICATIØN Lighting: Standard HVAC: Standard Plumbing; Standard Walls: Standard Sraooth finish is required Floor: Standard Smooth finish is required Ceiling: Standard Smooth finish is required

~~308 FACILITY NO. 075 DESCRIPTION Surgery WaLting Room NO. OF UNITS 1 NO. OF OCCUPANTS ^^ NET AREA 20^^^,^~~

~~FUNCTIONAL DESCRIPTION Assigned area to pro^vLde sitting facilities for indi"vidual vnaLting for nev;s about health status of family raemberswh o have undergone surgery.~~

ARGHITBCTURAL CONSIDEATION Lighting: Standard Acoustical: Standard Electrical: Standard HVAC: Standard Commurdcations: Standard Walls: Standard Floor: Standard, carpeting is suggested, Ceiling: Standard

~~FURNITURE / BQUIPMENT Typical~~

~~309 FACILITY NO. 076 DESCRIPTION Sur.gical Supendsor's Office NO. OF UNITS ^ NO. OF OCCUPANTS NET AREA 100 Sg, Ft,~~

FUNCTIONAL DESCRIPTION Space assigned to surgical supervisor for prqgramming all surddal interventions, Also this space raay serve for holding sraall raeetings. Should be located near surgical department and indirect contact xdth hospital's general circulation spaces.

ARGHITECTURAL GONSIDERATION Lighting: Standard Acoustical: Standard Electrical: Standard HVAG: Standard Coraraunications: Standard Walls: Standard Floor: Standard, Carpetin,g is suggested Ceiling: Standard,

~~FURNITURE/BQUIPMENT Typical~~

~~310 FACILITY NO. 078 DESCRIPTION Sur,gica3- Clean Work Roora & Sto NO. OF UNITS ^ NO. OF OCCUPANTS ^ NET AREA 30 Sg. Ft.~~

~~FUNCTIONAL DESCRIPTION Space assigned for the asserably of clean raaterdalsuse d vdthin the surgical suite, should be located between to all surgery rooms. Sink & counter space is requirea,~~

ARGHITEGTORAL SPEGIFIGATIONS Li,ghting: Standard Accoustical: Standard Electrical Standard Plumbing: Standard Walls: Standard. Smooth finish is required Geiling: Standard, Smooth finish is required Floor: Standardr, Smooth finish is required

~~FURNITURE/Equipment: 1- Bulletin board 28" X 24" 1- Gabinet Open 1- Gabinet Closed I- Counter 1-Sink ví/bedpan flushing~~

~~311 FACILITY NO. 079 DESCRIPTION Surgery Dackroon NO. OF UNITS 1 NO. OF OCCUPANTS 1 NET AREA 100 So, Ft.~~

FUNCTIONAL DESCRIPTION Tlds area provides 3 space for the spot a development of /.-ray unit. It should be located adjacent to surgery rooms. Should contain a complete film developing laboratory. It should be lightprooi vdth vrork counter a id storage space.

ARCHIT;JI;TURAL SPEGIFIGATIONS: Lightin,;;: Red li;^ht shoiiLd be pro^vdded for devclooin~ procedures and 70 footcandles, Lighting should be oro"videi;. for rcgular non-developing procedures. HVAG: Room should be pro^viaed vdth exhaust for fan ventilation, Plumbing: Standard Walls: Standard. Smooth finish is required Floors: Standard smooth finish is required Geiling: Standard, Smooth finish is required.

~~FURI^IETURE/EQUIPI-ÍENT 1- Sink 1-Tank developing I-Work counter 2-StooI~~

~~312 FACILITY NO. 080 DESCRIPTION Anesthesist's Room NO. OF UNITS 1 NO. OF OCCUPANTS i NET AREA 150 Sc^.. Ft.~~

FUNGTIONAL DESCRIPTION This area is used by the anesthesist for v'ritin; rcoorts, and stafi's work schedule, Should be converdent to oost-sur,'';cry recovery room anc should be separated by a glased partition víhich vdll proviac Id.Ti vdth "vdsual observation of patie"nts and personnel u"nder Ids responsibility a stora^^e area shoiiLd be adjacent to the anesthesist room.

ARGHITBCTUAL CONSIDERATION Lighting: Standard Acoustical: Standard j lectrical: Standarcd HVAG: Standard Plumbing: Standard Walls: Standard. Smooth firdsh is required Eloor: Stanclard Smooth finish is required Ceiling: Standard. Smooth finish is required

~~FURÍIITURB/BQUIPMENT : 1- Storage cabinet 1- Lavbtory ví/goose neck spout 1- Shelf over lavatorj^ 1- anesthesia table~~

~~313 FACILITY NO. osi DESCRIPTION Sur-ical Substerlisin: Room NO. OF UNITS I NO. OF OCCUPANTS 2 NET AREA 2/,5 oo, Feet.~~

FUNGTIONAL DESCRIPTION Space assigned for sterilisation facilities :dtldn the surd^al suite Should have direct access to each pair of sur'^ery rooms and corridor. Water sterilizers and "oressure sterilizers shotdd be built in vdth access for servicing,

ARGKTTECTUAL CONSIDERATION Lighting: Standard Acoustical: Standard Electrical: Standard HVAL: Standard Plumbing Hot and cold steidle v/ater supply. Walls: Standard. Smooth firdsh is required Floor: Standard. Smooth finish is required Ceiling: Standard. Smooth finish is req"uired

~~314 FACILITY NO. 082 DESCRIPTION ;Gur-ical Doctor's LounTe & Lcciccrs NO. OF UNITS 1 NO. OF OCCUPANTS 12 NET AREA 340 So. Ft,~~

FUNGTIONAL DESCRIPTION Space "oro"videa for rest and changing clothes before and after sur'^ical interventions. Locker room should. be adjacent to loun'"c. Space xor removal of scrub suites and boots shall be desi.gned so that personnel using it vdll avoid physical contact vdth clean personnel,

mGHIT EGTURAL GONSIDERATION Lighting: Standard Acoustical: Standard Electrical Standard HVAG: Standard Gomm"unications: Standard Plumbing: Provide hot and cold water lines and drainage. l'Jalls; Standard Flour: Standard Geiling: Standard

~~FUR nTURE/EQUIPMENT: Tjrpical~~

~~315 FACILITY NO. O83 DESCRIPTION Surgical Nurse's Loun^ e Lockers NO. OF UNITS 1 NO. OF OCCUPANTS 12 NET AREA 300 Sg. Ft.~~

FUNGTIONAL DESCRIPTION Space pro"vdded for rest and chandng clothes befcre and after sur"dcal. Locker room should be adjacent to lounge. Locker room should be pro"vdded vdth shovjer and toilet facilities. Area should be dessigned so that personnel entering cloth changing areas from surgical suite can chan-e, shovíer, govm and move cdrectly into surgerj^ room. Space fcr removal of scrub suits and boots shall be desi,gned so that personnel using it vdll avoid ohysical contact vdth clean personnel.

~~ARGHITECTURAL GONSIDERATIONS: Lighting: St andard Accoustical: Standard Electrical; Standard HVAG: Standard Gornmunications: Standard Walls: Standard Floor: Standard Ceiling: Standard~~

~~FURNITURE/ B3UIPI4BNTS: 1- Bulletin board 26" X 24" 16- Lockers 2- Easy, chairs 2- Chair, straight I- Laundry, shute 2-Table end 1 Table 24" X 36"~~

~~316 1- Management svdvel chair 6- Straight conference chair 1-Bookcase~~

~~317 EMERGENCY CARE UNIT~~

~~Room -Eleraents Wet Sq.Ft.Reouired~~

~~084 Waiting Area/Toilets 200~~

~~085 Surgery Roora 280~~

~~086 Bxaraination/Treatraent 250~~

~~087 Nurses' Station 100~~

~~088 Observation Area 205~~

~~Usual Area 510~~

~~1,545 Sq.Ft.~~

~~318 FACILITY NO. 084 DESCRIPTION Ebergency Waiting Area NO. OF UNITS I NO. OF OCCUPANTS lo NET AREA 200 Sq. Ft.~~

FUNCTIONAL DESCRIPTION Assigned area to pro"vide sitting facilities for children and parents waiting to be attended for emergency treatraent. Reception is and control station should be located adjacent. Space should be also adjacent to eraergency sidte entry. Should contain restroom for men and women. An anteroora is also suggested,

ARGHITECTURAL CONSIDEEATION Lighting: Standard Accoustical: Standard Electrical: Standard HVAC; Standard Commurdcations: Telephone outlets should be provided for public telephones receptiordst and control station, Outlets for intercom sho\ild also be provided,

~~FURNITURE/BQUIPMENT~~

~~319 FACILITY NO. O85 DESCRIPTION Bmergency Surgery Room NO. OF UNITS ^ NO. OF OCCUPANTS 3 NET AREA 280 Sq. Ft.~~

FUNCTIONAL DESCRIPTION This surgery roora is a rainor surgery unit. This space is assigned to provLde emergency surgical services to patients arri"ving "via eraergency entrance, The scmp-up and utility facilities are provLded vdthin the space, Room raay be also used for plaster work, Should be convenientiy located near ambulance entrance and accesible by a vestibule and to raajor surgery roora.

~~ARCHITEGTURAL CONSIDERATIONS Lighting: 200 Footcandles general illuraination and 2500 footcandles supple-~~

mentary on table. Accoustical: Standard Electrical: Standard, an additional receptable for portable x-ray raachine should be provided. All outlets should be located 5'-0" above floor. Communications: Standard Plurabing; Standard. Oxygen, suction and corapressed air outlets should be

~~pro"vided. Wall: Standard. Sraooth surface is required Floor: Standard. Sraooth surface is required. Ceiling: Standard, Sraooth surface is required,~~

~~FURNITURE/BQUIPMENT ; Sirailar to the Major Operating Roora,~~

~~320 FACILITY NO. 086 DESCRIPTION Elnergency Exeraination and treatraent Rooi NO. OF UNITS 1 NO. OF OCCUPANTS ^ NET AREA 250 Sq. Ft.~~

FUNCTIONAL DESCRIPTION This space is for exaraination purposes, there raust be sufficient space to perrait use of equipraent, such as x-ray. Access to the patient must be from all sides, Cabinets for raedicationan d equipraent should be provided.

FUNCTIONAL REQUIREMENTS. Lighting: 100 Footcandles for general illuraination and additional 2000 footcandles for over exaraination tables. Acoustical: Standard Electrical: 110 U duplex outlet should be provided on all walls. HVAC; Standard Plumbing: Standard Walls; Standard. Smooth finish is required Floor: Standard. Smooth finish is required Ceiling: Standard. Smooth finish is req\dred. Walls: Standard Floor: Standard, Carpeting is suggested Ceiling; Standard Plurabing: Water supply lines and drainage should be provided for water cooler and restroora.

~~FURNITURE/ BQUIPMENT: Typical~~

~~321 FACILITY NO. 087 DESCRIPTION Einergency Dept. Nurses's Station NO. OF UNITS 1 NO. OF OCCUPANTS 3 NET AREA loo Sq. Ft, ^~~

FUNCTIONAL DESCRIPTION Space assigned to pro"VÍde nurses vdth facilities to chart and re-vlew clirdcal records. control acti^vity flow within eraergency treatment and diagnostic rooms and to nurses with direct •view of all raedical observation beds. Work counter should be provided. The space provided should be - adequate for all clerical functions of nurses and physicians. It should be converdently located to reception area, treatment and observation areas.

ARCHITECTURAL CONSIDERATIONS Lighting: Standard Electrical; Standard HVAC: Standard Plumbing; Standard. Comraunications: Standard Walls; Standard Floor: Standard Ceiling: Standard FURNITURE/BQUIPMBNT Typical.

~~322 FACILITY NO. 088 DESCRIPTION Emergency Observation Area NO. OF UNITS 1 NO. OF OCCUPANTS ^ NET AREA ^°^ ^q- ^'~~

FUNCTIONAL DESCRIPTION: Space designated for patients in shock, raoribund patients. the space should be eqidpped vdth the facilities necessary to convert it into an adequate actue treatraent facility in times of peak load or mass casualities. Should be located convenient to examination and treatments Rooms,

ARGHITECTURAL CONSIDERATIONS Lighting: Standard Acoustical: Standard ELectrical; Standard HVAG; Standard Comraurdcations: Standard Plurabing: Oxygen and suction supply outlets should be provided. Walls; Standard Floor; Standard Geiling; Standard FURNITURE/BQUIPMENT Typical

~~323 NOTE; The Einergency unit raust have sufficient storage facilities for such \) equipment as wheelchairs, portable x-ray, instrurnents, linen and~~

~~housekeepin,g supplies.~~

~~324 AUXILIARY SUPPORT FACILITIES~~

~~# Room Elements Net Sq.Ft.Reouirea~~

~~089 Laboratory 745 Sq.Ft.~~

~~090 Radiology & Eiooroscpic Rm 300~~

~~091 Radiolo.gist's Office I6O~~

~~092 Processing Room 200 (Other Areas) 426 093 Theraphy B>:-room 100~~

~~094 Hyprotherapy Room 200~~

~~095 Locker & Shower Rm, 300~~

~~096 Therapist's Office 100~~

~~097 Ekg.Bmr & Speciemen Rm 207~~

~~098 Pharmacy 400~~

~~099 Autopsy Rm 1,137 100 Kitchen 2,845~~

~~101 Forraula Roora 255~~

~~102 Dining Room 7^:5~~

~~103 Laudry -»345~~

~~104 Central Linen Room ^00_~~

~~12,905 Sq.x^t.~~

~~325 FACILITY NO. O89 DESCRIPTION Laboratory NO OF UNITS l NO. OF OCCUPANTS 745 Sq, ít. NET AREA~~

~~FUNCTIONAL DESCRIPTION~~

~~Laboratory space needed for hematology, chendcal clinic, and emergency~~

~~laboratories. Research and experdmental laboratory procedures are perform~~

~~vdthin this space, It should be located on the first floor for the out-~~

~~patient clirdc and medical recorci office, An area provided idth cubicles~~

~~should be provided for taking specimen samples. A waiting area and a~~

~~veninptured room should be contained within this urdt,~~

~~FUNCTIONAL REQUIREMBNTS~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Gommunications: Standard~~

~~Plumbing:Standard, floor drain should be provided.~~

~~V/alI: Standard. Ceramic tiles~~

~~Floor: Standard. Cerandc tiles~~

~~Geiling; Standard~~

~~FURNITURB/EQUIPMENT~~

~~1-Gounter 1- Hood fume~~

~~326 FACILITY NO. 090 DESCRIPTION Radiology and Fluoroscric Room NO. OF UNITS 1 NO. OF OCCUPANTS 3 NET AREA 300 Sq, Ft.~~

FUNCTIONAL DESCRIPTION Space pro^vided for examination and diagnostic of patients using pariological and fluorscopical equipment, Tvro dreesing rooms should be pro"vided. This unit should be conveniently accesible to the inpatient and outpatient areas and as close as possible to emergency facilities,

~~ARGHITBGTURAL CONSIDERATIONS Lighting: Standard Electricalt Standard UVAC: Standard Walls: Standard Floor: Standard Ceiling: Standard~~

~~FURNITURE/EQUIPMENT : 2- Cabinet low 2- Cabinet, recessed 1- sink, w/ gooseneck 2- Radiographic and fluoroscope urdt 2- Stool, adjustable 1- Stool, foot~~

~~327 FACILITY NO. 091 DESCRIPTION Radiologist's office NO. OF UNITS 1 NO. OF OCCUPANTS 1 NET AREA 100 Sq, Ft.~~

~~FUNGTIONAL DESCRIPTION~~

~~Space designated for consultation between hospital's medical staff and chief radiologist. It should be adjacent to racdological departraent interdor spaces and to patient waiting area.~~

~~ARCHITECTUAL CONSIDERATION~~

~~Lighting: Standard.~~

~~Acoustical: Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Gommurdcations: Standard~~

~~Walls: Standard~~

~~Floor: Standard . Carpeting is suggested~~

~~Ceiling: Standard,~~

~~328 FACILITY NO. 092 DESCRIPTION Radiology film Processing Room NO. OF UNITS 1 NO. OF OCCUPANTS 1 NET AREA 200 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Radiographic plates are developed in this space, Should contain a~~

~~complete filra developing Laboratory. Should be located adjacent to radiolo-~~

~~gical roora. Work counter vdth sink and storage space should be pro"vided.~~

~~FUNCTIONAL RBQUIREMENTS~~

~~Lighting: Standard. Red light should be provided for illuraination.~~

~~HVAC: Standard~~

~~Plurabing; Standard~~

~~Walls; Standard~~

~~Floor; Standard~~

~~Ceiling; Standard~~

~~FURNITURE/BQUIPMENT;~~

~~Sarae as surgical's dark roora.~~

~~329 FACILITY NO. 093 DESCRIPTION Physical Theraphy Ex-Roora NO. OF UNITS 1 NO. OF OCCUPANTS 2 NET AREA 100 Sq. Ft,~~

~~FUNCTIONAL DESCRIPTION~~

~~This roora is where diagnostic and day to day evalution of patients~~

~~suffering frora cardiovascular and rauscular diseases or deficiencies are~~

~~perforraed. Should be accesible to the inpatient. Should have acceses to~~

~~waiting roora and theraphy facilities.~~

~~ARGHITECTURAL GONSIDERATIONS~~

~~Lighting: Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Walls: Standard~~

~~Floor; Standard~~

~~Ceiling: Standard~~

~~FURNITURE/BQUIPMENT~~

~~1-exercise roora~~

~~1- Bars, parallel~~

~~1- Bars, stall~~

~~1- Pulley weights~~

~~1- 6 tiers shelf~~

~~1- Bar walking~~

~~1- Bicycle, stationary~~

~~2- Footrest~~

~~330 1- Mat gyra~~

~~2- Table 24" X 60"~~

~~1- Table treatraent~~

~~1- Wheel shoulder~~

~~331 FACILITY NO. 094 DESCRIPTION Hydrotherapy Room NO. OF UNITS 1 NO. OF OCCUPANTS 3 NET AREA 200 Sg. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

Roora assigned to pro"vdde therapy treatment to patients suffering from v"í,*

~~rauscular or cardiovascular disorders;it irivol'yies. the use of water in~~

~~motion as their main treatraent concept. Roora should contain hoist to life~~

~~and lower patients in and out of hydrotherpy tanks.~~

~~ARGHITECTURAL GONSIDERATIONS~~

~~Lighting: Standard~~

~~Acustical: Standard~~

~~Electrical: Standard~~

~~Goramurdcations; Standard~~

~~Plurabing: Standard~~

~~Walls: Standard~~

~~Floor; Standard~~

~~Ceiling; Standard~~

~~332 FACILITY NO. 095 DESCRIPTION Locker and shov/er Roora NO. OF UNITS 2 @ 150 Sq, Ft, Each NO. OF OCCUPANTS 6 NET AREA 300 Sg, Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space assigned to patients requirdng treatraent for changing into special~~

~~clothing as reqrdred, Should be adjacent to the therapy rooras. And should~~

~~included shower and toilet facilities.~~

~~FUNCTIONAL REQUIREMENTS~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~Electrical; Standard~~

~~Coraraurdcations; Standard~~

~~Walls: Standard. Gerandc tile is recoramended~~

~~Floor: Standard~~

~~Geiling; Standard~~

~~FURNITURE/BQUIPMENT~~

~~Typical~~

~~333 FACILITY NO. 096 DESCRIPTION Therapist's Office NO. OF UNITS 1 NO. OF OCCUPANTS 1 NET AREA 100 Sg. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space designated for consultations between department's staff and chief~~

~~therapist. Also serves as chief therapist's private office. Should be~~

~~converdent to therapeutic facilities & patient waiting area.~~

~~ARGHITBCTURAL CONSIDERATIONS~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~Electrical: Standard~~

~~HVAG: Standard~~

~~Comraunications: Standard~~

~~Walls: Standard~~

~~Ceilings: Standard~~

~~Floor: Standard~~

~~FURNITURE/BQUIPMEIW~~

~~Typical Office Furrdture.~~

~~33^ FACILITY NO. 97 DESCRIPTION EkgBmr & Speciraen Rooras NO. OF UNITS 1 NO. OF OCCUPANTS 3 NET AREA 207 Sq, Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Spaces provided for the patient to present himself and hâve specimens~~

~~of blood dravm for various purpose or a jar of feces or urine sample taken~~

~~in an adjoirdng toilet,~~

~~ARCHITBCTURAL CONSIDERATIONS~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~Electrical: Standard~~

~~HVAC: Standard~~

~~Plumbing; Standard~~

~~Walls: Standard~~

~~Floor: Standard~~

~~Ceiling: Standard~~

~~FURNITURE/BQUIPMBNT~~

~~2- Hook Strios~~

~~1- Hollywood Bed~~

~~I- Offiee chair~~

~~1-Blectrocardiograph~~

~~1- scale~~

~~I- Stool~~

~~1- Bedside table~~

~~1- Table office.~~

~~335 Ceiling: Standard~~

~~FURNITURE/BQUIPMENT :~~

~~2- Ghairs~~

~~1- Sectional type, combination w/and vdthout arms~~

~~3- Table (coffee, sectional and round)~~

~~336 FACILITY NO. ^g DESCRIPTION Pharmacy NO. OF UNITS 1 NO. OF OCCUPANTS 2 NET AREA 400 Sq. Pt.~~

FUNCTIONAL DESCRIPTION This space is pro"vdded for the preparation and compouncdng, counting and pouring, packaging, storage, and dispensing of drugs. A requirement of 200 Sq, Ft. for work space, 100 Sq.Ft. for drug storage and 100 Sq, Ft. for pharmacy's cdrectors compose the net area. Positiordng the pharraacy near the raain corridor and public flov; is advantagedusly.

~~ARGHITECTURAL CONSIDERATIONS Lighting: Standard Acoustical: Standard Lectrical: Standard HVAG: Standard Coramurdcations: Standard Walls: St andard Floor: Standard Ceilings: Standard~~

~~337 FACILITY NO. 99 DESCRIPTION Autopsy Room NO. OF UNITS ^ NO. OF OCCUPANTS 3 NET AREA 410 Sq. Ft,~~

~~FUNCTIONAL DESCRIPTION~~

~~Space pro"vided for the practice of cdsection and anatomical elements~~

~~of cadavers. Autoply room should include refrigerators for the preserva-~~

~~tion of cadavers and organs. Should be conveniently located to tne loaddng~~

~~plataform and discretely located vdthin the hospital.~~

~~ARGHITEGTURAL CONSIDERATION~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~Electrical: 110 V duplex outlet miniraura of 3 outlets should be pro"vided, and~~

~~additional outlets raarked for x-ray use should be provided.~~

~~HVAC: Standard, Independent ventilation required,~~

~~Walls: Standard. Sraooth finish required~~

~~Floor: Standard. Sraooth finish required~~

~~Ceiling. : Standard, Smooth finish required.~~

~~Plumbing: Water and drainage lines should be provided for vrork sink and~~

~~autopsy table. Floor drain shoulc be proviced.~~

~~FURNITURE/ EQUIPMENT:~~

~~I- Gabinet, below counter~~

~~6- Gabinet, speciraen~~

~~1- Counter, 36" high~~

~~1- Lavatory~~

~~1- Morturary refrigerator (3 bodies) 338 1- Sink, instruments, &. Scmb~~

~~I- Table, autopsy w/sink kick bucket~~

~~1- Scale autopsy~~

~~2- Stool foot~~

~~1- Table, instmment, Mayo~~

~~1- Table, steel l6" X 20"~~

~~1- Table, steel 30" X 48"~~

~~339 FACILITY NO. loo DESCRIPTION Kitchen NO. OF UNITS ^ NO. OF OCCUPANTS ^^ NET AREA 8^0 Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space assigned for food preparation and distribution, The kitchen is not~~

~~a merly raechardcalassembl y line for conveying food to the patients room,~~

~~Meals should reach the patients fresh, appropiately hot or cold, and therefore~~

~~there must be the least posible delay and handling of food, In designing~~

~~the kitchen space allocation for glass washing and sterilization of 100 Sq,~~

~~Ft,, 100 Sq. Ft. for storage, potwashing and dishwashing Area of 200 Sq.~~

~~Ft. the kithcen should be planned to accomraodate the equipment and~~

~~keeping the flow from preparation, to cooking, to serving.~~

~~ARGHITBGTURAL GONSIDEfiATIONS~~

~~Lighting: Standard~~

~~Accoustical: Standard~~

~~Electrical: Standard~~

~~HVAG: Standard~~

~~Walls; Standard. Ceramic tile should be provided~~

~~Floor Standard Ceiling: Standard, Ceraraic tile should be provided.~~

~~FURN TURE/BQUIPMENT:~~

~~Refer to kitchen manufactures.~~

~~340 FACILITY NO. lOi DESCRIPTION Pormula Room NO. OF UNITS ^ NO. OF OCCUPANTS 2 NET AREA 255 Sq, Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~The supervLsion of the infant formula bottles preparation is pro"vided~~

~~in these space. Bven though by its function the formula room is considered~~

~~part of the dietary ser^vices, it does not have a direct relationship with~~

~~the main kitchen services, Area should be located withing main kitchen area~~

~~and converdent to service entry and traffic corridor. Storage space to vdll~~

~~be needed.~~

~~ARCHITBGTURAL CONSIDERATION;~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~Electrical; Standard~~

~~HVAC: Standard Plumbing: BrovLde sterile not and cold water supply lines. Regular water~~

~~supply and floor drainage.~~

~~Walls: Standard ceramic tile is suggested.~~

~~Floor: Standard Smooth firdsh is required~~

~~Ceili"ng; Standard. Sraooth finish is required.~~

~~341 FACILITY NO. 102 DESCRIPTION ci^i ^^^^ NO. OF UNITS ^ NO. OF OCCUPANTS '^ . 120 Sq. Ft. NET AREA 58O Sq. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space prvided for the hospital's dirdng facilities. It should be~~

~~converdent to the raain kitchen and circulation corridor space. Facility~~

~~may be used by "vdsitors at one tirae or another. A serving line operation~~

~~is the raust comonly used in raodem health facilities.~~

~~ARCHITECTURAL GONSIDERATIONS~~

~~Lighting: Standard~~

~~Acoustical: Standard~~

~~Electrical: Standard~~

~~HVAC; Standard~~

~~Coraraurdcations; Standard~~

~~Walls; Standard~~

~~Floor; Standard~~

~~Ceiling; Standard~~

~~Plurabing: Standard,~~

~~342 FACILITY NO. 103 DESCRIPTION Laundry Processing Roora NO. OF UNITS 1 NO. OF OCCUPANTS 4 NET AREA 400 Sg, Fb,~~

~~FUNCTIONAL DESCRIPTION~~

~~Area pro"vdded for the washing, drying, pressing, and sewing of all sciled~~

~~linen articles within the hospital, Equipraent within laundry room should~~

~~be arranged as to pro^vide an urdntermped flow from the soiled linen room~~

~~through the laundry to the clean linen supply room. Araple space should~~

~~be located conveninent to hospital's service entry and elevators. Ceiling~~

~~height sho\ild be 12 feet ndrdmura.~~

~~ARCHITECTURAL GONSIDERATIONS~~

~~Lighting: Standard, Indirect lighting is required~~

~~Electrical: Standard~~

~~HVAC; Standard,~~

~~Plurabing; Provide hot and cold water supply lines for washers, vapor supply~~

~~lines for pressing raachines and drainage lines for all equipment, and floor~~

~~drain.~~

~~Floor: Standard~~

~~Walls: Standard, Cerandc tile is sug,gested~~

~~Ceiling: Standard~~

~~343 FACILITY NO. 104 DESCRIPTION Central Linen Room NO. OF UNITS 1 NO. OF OCCUPANTS ^~~

~~NET ^^^^ SOQ so. Ft.~~

~~FUNCTIONAL DESCRIPTION~~

~~Space pro"vided for the storage and supply of all linen articles to the~~

~~hospital. Pro^vdsion is necessary for blanket storage and sorting table.~~

~~Shel^vdng space is required. Central linen room should be located adjacent~~

~~to the "clean end" of the laundry room with converdent access to elevators.~~

~~ARGHITBGTURAL CONSIDERATION~~

~~Lighting; Standard~~

~~Electrical; Standard~~

~~HVAC: Standard~~

~~Walls: Standard~~

~~Floor: Standard~~

~~Geiling; Standard~~

~~344 CASE STUDIES~~

~~345 Texas Scottish Rite Hoe^nit-: For Crippled Children Dallas, Texas~~

~~Location: Dallas, Texas 2222 V/elbom.~~

~~Architects; Harwood K, Sraith and Partners, Norman Losa, Hospital Gonsultants~~

Gontext; To adapt the pediatric hospital in Dallas to its natural surroundings, the architects had to combine exterior and interior raaterdals, textures, and fu-^''r".sldngs to a colorful en^vironment, A 125-bed specialized teaching hospital, it consists of orthopecdc facilities, a large a'nbulator;' patient clirdc, a full range of rehabilitation ec uipment, and educational centers for patients vdth learrdng cds- abilities, Golorful and concise •;ig.':? are ccrit^;' throu;;'".- out the complex to facilitate patient and •visitor orient.C'- tion, For "visual interest, accent colors and grap^dcs depicting building blocks, children's faces, and fa-.dliar shapes and scenes are incorporated as part of the total interior decor, The hospital's colors outs dne drabness, instilling confidence in p.atients stmggli:\g to overcome the frustration and fear that are associatcd vdth a crippled body, It is a happy place; it was planned that v/ay

Functiont The complex is arranged into two major stmctures, one housing hospital activities and the other for ancillary services. The two buildings are interconnected by a transparent atrium or lobby, which serves as the heart of the complex and as an orientation point for visitors and patients, With a huge mobile as its focdJ aair-'^ the atrium

346 also includes a skylit section that uses umbrella covered tabl.-s to provide a cafo-iike extension to the hospital's dj.ning area, Form: To help create an environrnent for healthy child development, interior fumishings complement a Ya_r:i.ety of chan;:- ing spaces, tactile surfaces, and geometric fon.n.s, For a change of pace and focus, patterned fabrics accent quiet backgrounds, carpeted building blocks are arranged for children's seating areas, outdoor light from patient rooms illuminate subdued corridors, and solariums bring sunlight and blue.sky into patient floors. Linen, food, and medical supplies are dlstributed through- Qut the hospital via an exchange cart system accorded by a centralized management concept, The main kitc'ipn, '-.'hich is centrally locatea, transfers to subkitchens on each patient floor, Building System Analysis! Mechanical and electrical systems are controlled at a central station that is equipped 'd.th a computer to pro'v:lde continuous monitering and recording of hospital data, The stmcture, made of poured—in—place, reinforced concrete, has tv7o levels below grade and four levels above, Outside, tan brick walls blend vdth the adjacent park, Site Arialysis: Situated in a beautiful park setting, the hospital cnrnnlox was designed to take advantage of an elevated site, a landscape of large trees, and a panoramdc "view of the Dallas skyline, Floor masses of the building are offset at each level to serve as shades from the víestem sun, while balconies on the eastem side overlook Reverehon Park and the city of Dallas, Gost Analysis; Unavailable at this time.

~~347 United Children's Hosrdta 'St, Paul's Bloomingdale, M.innes^.t:í~~

~~Locatlon; Bloomingdale, Minnesota 333 Smith and Avenue N, St, Paul's~~

~~Architect: Ellerbe and Associates,~~

Gontext; The hospital, which has a cheerful, colorful facade, is terraced to break up the raonolithic nature of the building's walls and to highlight the building's windows, There is a play area tucked into the landscaoing at the front of the hospital that is highly visible to approach- ing chdldren, As a result, the inviting outdoor play pro-vides children vdth a familiar sight to v/hich they can relate, This is reinforced by the general "aiting area, where rich priraar^/^ colors and large wall murals create a sense of fun and friendliness, In addition, an open play area adj?ccnt to the ad'^.lssion station pro^vides children id.th a comfortable en"vironment in víhich they can gradually adjust to the facility, Function; As children enter the patient care areas, they are greeted by •vi"vid colors, viall murals of ardmals, and open spaces surrounding the nurse's stations, This open space acts as a suppleraent to the play rooras on each corridor by pro^viding a space where the children can meet and congregate, These areas are regularly used for movies and conversational gatherings. The design on the hospital was extended to other areas id.thin the complex, The first floor delivery area provides sleeping rooms with baths for the families of matemity patients, and individual "mothering" rooms

348 are provided for nursing mothers whose children require additional hospitalization after their bii^h, Farri: A nurses» st^tion Is located at each end of the patient care area so that most of the patients' rooms B.r-e in clear line of vision to nurses' stations, which help to promote feelings of security and involvement in floor activities, The play rooms on each corrridor are joined to walled, wooden terraces that pro-vide an opportunity for the chdldren to play outside, The individual patients' rooms are separated by cdviders that can be opened to pemdt the children to commijinicate and play vdth neighboring patients, In addition, each room contains a sleeping space so that parents v;ho vdsh to spend the night can do so comfortably, Lov.ror floor roofs are used as upper floor terraces to allow children pleasant, open access to the outdoors. Builcdng Systems Analysis; The hospital is a triangular-shaped, four storjr stmcture vdth a burrdshed, red brick exterior, The nevr facilit^.^'s exterior color complements the general upbeat nature of the com.munity, Elevators and builddng services are located centrally in a central core structure, Site Analy is; The hospital is nestled in the midst of a residential neighborhood near dovmtovrn, The buildings' loví profile creates a vrarm, unimposing facade that blends harrnord- ously with the surrouncdng neighborhood, The terraces are comfortable even in the vdnter because of their southern exposure, The ll6-bed hospital relates to a well-defined urban landscape and the existing hospital complex vdth wld.-;""! the new facility was integrated.

~~349 Gost í\nalyri:3; The hospital has a $14 million budget and 105,000 square foot space allocation.~~

~~350 Ambulatory Gare Addltion Memorial Hospital Charleston, West Virginia,~~

Location: Medial Center, Charleston, West Virgirda Brooks Street and Elmwood Avenue Architects! James L, Haack & associates Sverdrop & parcel and Associates, Engineers Context; Aware of the fact that quiltraaking is a finely developed craft in West Virginia, the architects decided to incorporate this craft as part of thier bidlding design by suggesting a hexagonal pattera for the clinic modules vdthin the builciing, In addition, craftsvromen in the coraraurdty created 25 hexagonal qidlts, xirhich vary in color and pattem, to be used as víall hangirvgs. The quilts are individ'.ially framed and are asserabled in an abstract fashion on the raain víall ta the atrium, Thus, anyone moving through the building can see the colorful quiltwork, which coincides vdth the organization and geometry of the building, Another homelike touch is the use of plants, raostly in the atrium, in which there are a variety of trees and tropical plants, and also throughout the building, The maintenance cost for the plants is minimal because the vjomen's auxiliary asstimes this re sponsibility, Form; The addition is connected to the hospital by an atriura and includes two clinics on the ground floor - one housing special medical servLces and the other a routine, non- emergency , ''.^.-hou.r, xiaOJc-in clinic. Both are accessibie by the eraergency and main extrances of the new building. Also, part of the ainbniaT.or- care facilities includes an

351 outpatient surgery facility, chemo^therapy facility, a dental clinic, and an outpatient pharmacy. Other floors Gontain the medical records department, a combined medical intensive care/coronary care uidt, and a recovery room/surgi'-al intensive care imit, The wRÍting area i- broken into seating areas that accommodate up to eight or •rn.n.e persons each, This arrangement encourages the local custom of entire families accomoa^ajd.ng ambulatory care patients to the clirD.c, In addition, because many toddlers and preschoo ers often come along, there is a play area in the víaiting room with activity space for toys and tele"vdsion that allovrs visual supervision by the parents, Function; One of the most challenging aspects of the nevj adddtion vras the need to find a v/ay to connect a less institutional- looking addition to the c."Í5ti'.ag hospital building, An atrium that accommodates different floor-to—ceiling heights between the nevj building and the old was designed for this purpose, The atriarr serves as a center for public circulation and as a passage for parties vi?"^ting both buildings, Along with abundant natural light and ^Teenery, the atrium uses colorful handmade quilts to make p- ti.ents and visitors more comfortable, Building Systems Analysis; The cliric is connected to the atrium by a four^storj.^ building. The clinic is arranged in a hexagonal group of four rooms, The hexagonal pattern vjas chosen for several reasons. First it eliminates the traditional corridor providdng access to a row of exandnation rooms. Second, it makes it possible to separate the waiting area from the examination area, a.ric, .finally, it allows the waiting room to be a large, open area.

352 Due to the fact that the vjaitip'^ area faces south a^nd is subject to the heat and light of the sun all day, an overhang vras constructed so that the glass facade is shadecl year round, Tinted vdndov/s were install.^d and abundant landscaping vras done surrounding the buildings and the dentistry care area so that patients can look out onto a green landscape area, An earth beam blocks the "vdew of the street across the v.'ay and shields the patients from the -n-eM of passeríi;.'.

~~.os^i Cost per square foot is $65, a figure hospital admini.s- trators determined was vrell beloví the national average for a hospital that avoids the tra'ditional, institutional- ized atmosphere.~~

~~353 CONCLUSION~~

~~354 GONGLUSION;~~

The Ideas contained in this section for minimizing anxiety in the hospitalized children have been successful by many children's hospital in the United States. Although each institution has several good ideas for improving pediatric care. I have selected what I feel to be the most significant idea from each hospital,

My goal is that the designer (s) will benefit from these ideas and from the sources used throughout the program . By giving careful consideration , he should apply his knowledge to the benefit of the children's comfort during their hospital stay. Most of these ideas should not be limited only to children's hospital, but can be appl ed to a child..dn any hea th care institutlon, EXAMPLE5; The pediatric unit of the Colorado General Hospital in Denver has a urdque concept; "To an adult water may mean only washing and drinking. To a child it may mean at least washing, drinking, and f>lay -—", In the hospital setting water offers play opportunities, even for especially weak or physically handicapped children. Refer to illustration #l'í -^ Children's hospital at S-tanford consists of four clustered nursing units. Each cluster is self-contained for a cer-tain age group and is an architecturally independent, identifiable unit (see Plan 6). St. Luke's Hospital in St. Paul, Mirmeso-ta, Mercy Hospi-tal in Redding, Califorrda, and the protypical college health center of the Educational Facilities Laboratories use the circular cluster (see Plans 7"8)«

355 L ncoln General Hospital in Mncoln, Nebraska, provides an example of a basically configuration achieved with a rectangular building system (see Plan 9). The Boston Floating Hospital proposal demonstrated the use of small ten-bed cluster within the large building necessary in an urban medical center (see Plan lO),

~~356 Drawing #1~~

~~357 Plan 6. Cluster Units oí Double Corridor Core Childrens Hospital at Stanford, PaloAlto, Califomia~~

~~close relationship between indoors and outdoors~~

~~central nurses' station views , activity throughout unit, including play areas~~

~~special facilides •• accessible to all four units~~

~~long corridor made pleasant by frequent landscaped courtyards~~

~~358 Plan 7. Grouped Circular Clusters St. Luke's Hospital, St. Paul, Minnesota~~

~~direct access from day room to outdoor area~~

~~single, controlled access for aU three units~~

~~play space -vvithin the unit, necessary f or pediatric use~~

~~nurses' statíon has visibiLity of all patient rooms~~

~~359 Plan 8. Circular Cluster Above: Protypical College Health Center Below: Pediatrics Pavihon, Mcrcy Hospitai, Redding, Califomia~~

~~raised nurses' station four-bed rooms can be has clear view of used as double rooms aU areas in unit when needed~~

~~cLLnic adjacent to inpatient areas~~

~~suggested nurses' quarters couid function as parent relaxation/hostel area~~

~~single access point~~

~~most patient areas~~

~~visiblc from nurses ^^•- stalion Wr;^~~

~~level access to outdoors~~

~~360 Plan 9. Grouped Rectilinear Clusters Lincoln General Hospital, Lincoln, Nebraska~~

~~single access point~~

~~central core ofîers each unit access to speciaiized facilides~~

~~aU patíent areas visible from nurses' off-center nurses' statíon station for less intensive care~~

~~361 ! — 1— -- small ten-patient :'LL' f nursing units a'—^~~

~~D Q C ti--cr-n~~

~~r • i 1~~

~~Plan 10. Grouped Rectangular Clusters Proposal for Boston Floatíng Hospital, Tufts-New England Medical Center~~

~~362 BIBLIOGRAPHY~~

~~363 BIBLIOGRAPHY~~

]), Bruce M, Thogmartin, Design for Ob.stetric and Pediatric Facíli.tie... Ross Laboratories, Columbus, Ohio, 1977, 2), Botsford, G,î'f, Ancient History, New Yorkj American Book, Inc, I956. 3). Charles Butler, Addison Erdman, Hospital Planning. F. W, Dodge Corporation, New York, New York, I946, 4). Charles G. Ramsey and Harold R, Sleeper, Architectural Graphic Stand- ards, 6th and 7th Edition, John Wiley and Sons, New York, 197O. 5). Department of Planning, Research and Development, City of El Paso, El Paso, Texas 1979, 6), Dodge Building Gost Services, Hospital Health Care Building Costs. Mc Graw-Hill, In.fonnation Systems Co,, New York, I976, 7). Encyclopedia Americans. New York,, Vol, I4., 1949, 8). Donald S. Basler. Planning and Design for Pediatric and Prenatal Facilities. Ross Laboratories, Columbus, Ohio, I977 (# 43216). 9). El Paso & Cd. Juarez, Social & Economic Characteristics, Steven W, Kent., 1977. 10.) El Paso Chamber of Commerce. The EL Paso Area Fact Book, 198-82 Edition. El Paso, Texas. 11). El Paso Industrial Location Information Fact Book, 197I-72 Edition, 12), Hill Burton, Adrainistrative Services and Facilities for Hospitals, A, Plarming Guide, U,S, Govemment Printing Office, Washington, D,G, # 20402, 13). Intemational Boundary and Water Gommission, Mexican Section. Gd, Juarez, Ghih, 14). Job Descriptions and Qrgardzational Analysis for Hospital Related Health Services, J.S. Department of Labor, U.S, Govemment Prdnting Office. Washington, 1952. 15), Local Glimatological Data, EL Paso, Texas. U. S, Department of Gommerce, National Oceanphic and Atraospheric Admirdstration, Ehvironment Data Service, 1973. 16), Margaret Co íden Bemard. The Hospital Dietarv^ Department, Burges PubUshing Co,, Minneapolis, -dnnesota, 1954, 364 17). Owen B. Hardy And Lawrence P. Lammers Hospitals, The Planning Arrd Desiffl Process. Aspen Systems Corp,, Germantown, Maryland, 1977. 18). Planning The Surgical Suite, F.W. Dodge Corp., New York, 196O, 19). Putsep Ervin. Planning of Surgical Genters. Second Edition. Ervin Píltsep. Sweden, I969. 20). Rosenfield. Isadore. Hospita]., Integrated Design. Reinhold, New,York, 1951. 21). Roslyn Lindheim, Helen H. Glaser and Ghristie Goffin. Ghanging Hospital Environments For Children. Harvard University Press, Cambridge, Massachusetts, 1972. 22), Seidel, Douglas. Architectural Program. Texas Tech University, Lubbock, Texas, December, 1974, 23). Southwest Business and Economic Re-view. Bureau of Business and Economic Research, May, 1980. Vol. 4, page 20-25, 24). Rosenfield Isadore, Hospital Architecture And Beyond, Reinhold Book Gompany, New York, I967. 25). U.S, Department of Health, Edueation And Welfare. Minimum Require- ments 6f Gonstruction And Equipment For General Hospital And Medical Facilities. 26). U.S. Department of Health, Education And Welfare, Facility Planning Guide For Ambulatory Health Genters, Bethesda, Maryland, 1980^. 27). Reynaldo Vargas, Architectural Program For Mc Allen Medical Center, Texas Tech Urdversity, Lubbock, Texas. Deceraber, 1975. 28), Warwick Smith. Planrdng he Surgical Suite. F,W, Dodge Corp,, New York, I96O. 29). Todd E. Wheeler, Hospital Design And Function. Mc Graví-Hill Book Company, Inc, New York, I964.

~~365 DOCUMENTATION PROJECT PURPOSE~~

The purpose of this project was to create an environmental space more suitable for children's psychological well being during medical treatment. The new facility provides the city of El Paso and its surrounding conmunities with the most efficient, complete, modern, and pleasant care available especially for children at a reasonable cost.

~~THE SITE~~

The site consists of 9.2 acres of land and contains parking areas for approximately 225 vehicles. Parking areas are subdivided into 150 spaces assigned for visitors and staff; and 56 for employees and 19 spaces have been provided for emergency parking which is located in front of the emergency entry. The emergency vehicle drive is accessible from the two ramps facing IH-IO. The service entrance is adjacent to the emergency entry, providing a second entry to the emergency unit of the hospital.

~~THE BUILDING~~

The overall design concept is based on the separation of the children's rooms from the main hospital facility including the outpatient clinic. Both facilities are linked by a corridor occurr- ing in all of the three floors. The complete facility consists of three floors consisting of approximately 145,000 square feet. A total of 110 beds are housed in this facility. In order to obtain maximum use of the available site a low profile structure was designed. The basement floor of the hospital contains the emergency and surgical departments on the west portion of the building. These two departments are closely related since they share some of the facilities such as the fracture room. The x-ray and laboratory departments are centrally located between the emergency and surgical departments also by being easily accessible to the patients' rooms via elevator. The observation care unit is contained within the surgical unit being conveniently accessible to the emergency unit as well. A visitor waiting area is located at the intersection of all the facilities. The hospital's pharmacy is located adjacent to the visitors' waiting area but is also easily accessible by the surgical and emergency unit as well. The hospital's morgue is also located in the basement with an exterior exit for quick and discrete disposal of the bodies. The laundry and maintenance departments are located on the north-east side of the floor. Food preparation and employees' cafeteria are also contained in the same location. The basement is accessible by vehicles by a vehicular ramp located on the south-west side. The emergency and ambulance entrance are protected from climatic conditions and both entrances are linked to visitors' waiting areas. The first floor of the hospital facility contains the admissions office, the outpatient clinic, cafeteria, and patients' rooms all of which are linked by a mall containing a gift shop and an outdoor café complemented by a MacDonalds outlet for children. The admission department is located on the south-east portion of the building. This department consists of two waiting areas, an information desk, the admitting and financial services departments. Facing the admissions area is the outpatient clinic which can expand to the second floor as future demands may require. This outpatient facility consists of examination rooms, waiting areas, treatment rooms, and a minor surgical unit. The area is serviced by elevators for the exclusive use of the outpatients and related medical staff. The cafeteria is situated on the north end of the building. Accommodations for 100 persons are provided for in the serving area. The actual food preparation takes place in the basement kitchen and prepared foods are transported to the serving area and patient rooms via specially designated elevators provided for this task. Not withstanding the large preparation cooking facility located in the basement, the first floor cafeteria is equipped with a smaller kitchen for the purpose of en- hancing the capacity of the large kitchen and to accommodate overflows at peak periods of the day. A glass covered roof joins the above mentioned facilities. The principal entrances are situated on the north and south portions of the building. The north entrance guides visitors to the cafeteria on one side and outpatient clinic on the other. The second (south) entrance leads to the admissions and financial services offices. The first floor patient rooms located on the west side, are segregated from the non-patient area by a glassed-in atrium serving both as a corridor and a shield from the patient waiting area. The patient care area housed on the first floor consists of two units. Both units are connected by a play area. Each unit consists of two nurses' stations and approximately 26 patients' beds. It houses two private rooms which can be converted to double occupancy. A play area for exclusive patient use is located at the extreme end of each unit. The supporting facilities are within the nursing unit on each corner providing visual contact to each room. A private elevator is situated at the entrance of each wing for patient transport between floors. Small play areas and waiting areas are strategically and unobstructedly located along the hallway. The second floor contains the hospital administrative offices, the second floor of the outpatient clinic, medical offices, and the two remaining nursing units. The administrative unit is located above the admitting and financial services departments. This unit houses executive and nursing staff offices each with its own conference and meeting rooms. Visitors' waiting areas, which were provided, view the mall below. This medical staff complex consists of offices for physicians, examination rooms, and treatment rooms. Similar accommodations are provided for the nursing unit area at the opposite end of the connecting corridor. The nursing area on the left however, provides additional facilities as required by the difference in functions and activities such as the intensive care unit and private parent care rooms for infants.

VERTICAL CIRCULATION A total of 7 elevators are provided as well as one dumbwaiter. Three elevators located adjacent to the main lobby are provided for publlc use. Two additional elevators are provlded to service and connect the nursing units, one in each end of the hospital's patient's wings. Another elevator is utilized to connect the two floors of the outpatient clinic. The final seventh elevator which is a freight elevator, serves all three levels providing a quick transport medium for food services and equipment. Adjacent to the freight elevator are chutes provided for trash and linens each with small collecting areas on each floor. The mall cafe is serviced by the dumbwaiter connecting it to the basement below. A total of six stairs are incorporated in the structure. Two are situated at the end of each nursing unit. Another stair is located at the rear providing entrance to the first floor lobby and niedical offices on the second level. These three stairs provide emergency exits for the upper and lower floors and comply with fire codes. The main stair facing the visitor elevators connects all three floors. The outpatient clinic contains one stair located in the center of the unit. The remaining stair links the financial and admitting services unit with executive offices.

~~STRUCTURAL SYSTEM~~

The hospital's structural system consists of reinforced concrete columns and a two way waffle slab. Precase concrete panels comprise the exterior skin for the entire structure. The use of these materials provide the most economical and efficient system available for this building type. This system requires the shortest construction time as compared to other conventional structural systems. Also by using a reinforced concrete structure noise transmission created by the mechanical system is greatly reduced. Frost free ceramic tile was utilized to provide the exterior colors.

MECHANICAL SYSTEM The mechanical system is a four pipe hot water-chilled system. An exterior Power Plant located at the extreme western end of the site houses all mechanical equipment. Piping is run through a tunnel from the power plant to the hospital facility. Once inside the hospital the piping is run in a mechanical space along circulation corridors. Mechanical spaces are provided throughout the three levels of the facility as required by the various functions. Fan coil units for patient rooms are located in a mechanical chase. AIl other areas are zoned and fan units located in a mechanical plenum above the cooling system. The intensive, emergency and surgical units have their specialized functions. Ventilation is provided through removable grilles also provided to all the equipment for maintenance and repair purposes.