LITERATURE REVIEW

 DEFINITION OF PAEDIATRICS
Paediatrics is the branch of medicine that deals with the care and development of
infants and children and with the prevention and treatment of their diseases. A
Paediatric centre is therefore a health-care facility for children.

 HISTORICAL DEVELOPMENT OF PAEDIATRIC CARE

Firstly in the western Europe, there was a gradual step to find separate spaces specially
for ill – children, partly to avoid exposing them to adults in general hospitals which
make them feel anxious
The first generally accepted paediatric centre is the Hospital des Enfants maladies
(Hospital for sick children) which was opened in Paris in June 1802.
The rise of paediatrics itself was directly related to the establishment of children’s
hospitals in the 19th century. This need for specialization has been keenly debated by
historians over the past 150 years and the perceived benefits of such a division of
labour within medicine were often greeted by suspicion or frank hostility by many
influential members of the profession.
As the field now increasing globally and with more interaction among doctors and
council members of health department and care givers worldwide, it is therefore
important to begin by giving more importance on its development over the years and
come up with new ways of improving the designs for future use and development.

• DIFFERENCE BETWEEN GENERAL HOSPITAL AND CHILDRENS HOSPITAL:

The concept of hospital design matters to transform the healthcare environment for
everyone who enter into the hospital. All the elements of healthcare are key
components for a health care system which helps in improving the health status of
individuals, families and communities.
Awareness about helathy and safe environments with the establishment of medical,
psycological and sociological aspects of design creates a base for desire to the childcare
facilities. Childhood presents an important age group, not only because of their
dependency to grow up, but because children are in a learing process of knowing
themselves and relating with other people and the world around.
Children are sensitive towards environments and hospitals for one can be an extreme
environment for them to cope up with as it challenges their daily routines, which
generates responses like anger, frustration, fear and anxiety.
Avoiding negative responses in a hospital environment is a key to support recovery
along with age appropriate design. They can also act as factors that can be manipulated
to obtain certain positive distractions with healthcare provisions, education, kid –
centric spaces, play areas and healing spaces.

 QUALITY OF A SPACE
Designing for young patients means inspiring confidence, encouraging playfulness and
offering hope. To fulfil this, hospitals and practices need high-performing and flexible
environments that can do excellent medical care, integrate technology, encourage
interaction and patient engagement, and a sense of comfort for all ages.
1. Design for engagement at all levels
2. Keep families in mind
3. Create neighbourhoods
4. Integrate flexible spaces
5. Considering efficiency, safety and security
6. Promote healing environments
7. Support caregivers
8. Connect to social networks
9. Consider population health impacts
  THE IMPACT OF HOSPITALIZATION ON CHILDREN
Hospitalization is a disorganising experience that may be create crisis for children. Sick
children, who are hospitalized, are usually taken away, often unexpectedly and
unwillingly from their home, family, school and friends, from a comforting familiarity
and play, to a new place, filled with constant activity, medical procedures [which may be
invasive and painful], nurses and physicians [which may not all be empathic and
pleasant], and-at times-separation from their parents.

Children in the hospitals confront many difficulties that require special needs and
among which, indicate the comforting needs, which may be wither physical, psycho
spiritual, social or environmental. Their behaviour keeps on changing based on the
above mentioned and hence behavioural tracking of children in the different spaces of
the paediatric settings helps to find something between the spaces and their attributes.
Taking Design guidelines from the behavioural perspective which when placed can
result in effective responses and interactions.

 INDOOR SPACES
A high quality indoor space needs to be clean, tidy, bright, colourful and spacious.
Maximum day lighting and not more artificial lightings important. Such an indoor space
makes the children feel happy, takes their minds off the trauma they go through in there
and facilitates quick healing.
Children doesn’t need luxury rooms and environment to feel happy, they need playful
environments to make them feel like home by creating homely environments.
  OUTDOOR SPACES
Some other researchers also pointed out that designers should take the same approach
to plan and prepare the outdoor space as they do for the indoor space Outdoor space.
Planning for outdoor space includes the provision of play and well elaborated landscape
areas such as healing gardens, yoga and meditation spaces which make them feel calm.
 PLAY SPACES
Preparing materials and activities designed to promote specific types of play and avoid
potential health risks, it is very important to provide a variety of play materials that are
changed on a regular basis-outdoors as well as indoors-to create interest and greater
participation by children Play space.
 DIFFERENT TYPES OF THERAPY:

1. NATURE THERAPY:
Nature is also a positive distraction which has proven to be known for health benefits
like reducing stress levels and other health related complaints.
The stress of hospitalization can be reduced by offering a space less complex than
hospital, with a more relaxing and familiar atmosphere, acting as a refuge.

2. ART THERAPY:
Paediatric hospitals offer a wider range of social activities than the general hospital,
where adults have high levels of isolation. Art is another positive distraction in
healthcare settings, which relives stress and mood which improves for all categories of
people present in the space.
 3. EDUCATION THERAPY:
Education is the main activity in childrens development, if children have to stay for
longer period of time, so educational programmes were created according to their ages.
Developing psychosocial well-being, and positive distraction from illness by providing
childrens library.

4. PLAY THERAPY:
Playing is an important part of children’s life. It not only provides enjoyment, but also
leads to an interaction and exploration of the environment. The positive activity
develops childrens social, intellectual, physical and emotional growth.

 Typical features of healthcare unit space include:

  CHALLENGES:
A key determinant of things that matters when it comes to health interventions – the
experience, cost, and results. Its is the buildings and spaces in which patients are
treated. The size and layout of a room, weather a bed sits in the middle or against a wall,
how much space is maintained for patients to walk versus how many beds or operating
equipment can be accommodated, have not been considered predictors of health
outcomes in the past.

 SENSE OF CONTROL
In general, general hospitals have established routines and rules that may lead to
patients helplessness. Lack of privacy, poor wayfinding, physical barriers and poor
communication are among the main reasons that showcase the feeling of lack of control
For a better balance, the ‘self-supporting systems’ approach, enabling an increase of
control through the design of physical settings. One example can be enabling room
changes such as position of the bed, the degree of natural light or sound such as
television or music.
  One of the aspects that influence the sense of control is WAYFINDING. It is
considered as a ‘spatial problem solving’. An imaginary of the space layout is
required for a spacial orientation. Understanding the actual location, the
destination location, the route to choose, to follow that route or when the
destination is reached, are part of the problem-solving process.
 The use of clinical terminology seems confusing to children, but the use of
colours to differentiate areas seems suitable for all ages. other examples are the
use of mosaics, floor markers, signs or even artwork as landmarks, which can be
associated as reference points. It helps to provide a calming distraction and also
act as navigational landmarks.
 PRIVACY is another factor closely related with control. Both privacy and
socialization are important factors if balanced in an effective way can offer a
better hospital environment. It enables the controlled access to personal space or
to the groups to which one belongs.
 PERSONALIZATION attributes children the possibility to manipulate their
environment, being an important element of control. This is an appreciated
aspect of hospitals ‘capacity of adaptability and flexibility’

 WHY DOES LOCATION MATTER?

There are numerous factors that influence the provision of hospitals and their ability to
provide equitable access to care services. One of the prominent factors amongst them is
the location. In a country like India, its especially important as a significant bulk of the
population resides in the rural and remote areas where access to healthcare is minimal.
  CRITERIA
The indicators used were grouped into the general knowledge, practice and perception
of the child health specialists, the children themselves and the parents or guardian as
follows:
1. Children criteria:
• Age
• Gender
• Health condition
• Type of family
• Comfortability and Conduciveness of spaces
• Expectations
2. Parents/ guardians criteria:
• Conditions of child
• Expectations of a child health centre
• Comfortability
• Variety of spaces

 SPECIAL STUDY
 Therapeutic/healing gardens:
Throughout history gardens have been used to aid in the healing process - from the
Japanese Zen Garden to the Monastic Cloister Garden. However, with the advances in
medical technology in the 20th century, the use of gardens as healing elements began to
reduce.
 Children’s Gardens:
I. Make all entrances welcoming and child-friendly. Provide differentiation of spaces
for preadolescent and adolescent groups, if appropriate.
II. Provide a comfortable social environment with plenty of places for parents and staff
to sit and share the space with children.
III. Provide as many options as possible for children to interact with nature through
their senses and/or hands-on activities.
IV. Provide opportunities for planting and harvesting.

• Play and learning areas:

Play space is required and so is space for teaching, these are usually shared with other
functions so that a home like setting escheated to aid the natural healing process. This
becomes one of the concepts of this design thesis. This will evolve the creation of a
friendly and a CHILD-FOCUSSED DESIGN.
The play areas will comprise indoor and outdoor areas.
(i) Indoor Play Spaces The indoor play space will include large open floor spaces
with indoor game facilities.
(ii) Outdoor Play Spaces The outdoor spaces will include well landscape areas
with play equipment. These play areas usually have at least one seat or bench
suitable for adults.
(iii) Learning /Class Rooms Classrooms are very necessary in paediatric unit to
help children continue their formal education. An inclusion of such a space in
the design, makes the hospital a more complete and friendly space for the
children

 POSITIVE DISTRACTIONS:
positive distraction in paediatrics is influenced by many factors which demonstrate
positive influence on patients undergoing treatment or procedure. A healthcare
environment provide a series of health benefits for patients, including improved
behavioural and emotional well-being, reduced stress and anxiety, enhanced healthcare
experience and satisfaction, and facilitated medical procedures and recovery.
 • Children and colour – its effects on them
Colour schemes for children facilities include the predominant use of the three primary
colours of red, blue and green. The careful selection of these colours can be used to
paint the wards, the reception, and other areas where necessary. The selection can be
made from combination of colours of the colour wheel or chart.
Each element plays a role, from colour, materials, textures to lighting and
configurations.
It all contributes to childrens learning milestone which is one of the major design
strategy implementations of this module.
Red: It is known as a sociable and lively colour which best stimulates excitement in
children. It could be used in children’s play room with a combination of yellow, orange
or purple. It should never be used in a baby’s bedroom
Green: This is the colour of concentration and intellect, calming in a neutral, positive
sense and the most restful colour to the eye. It promotes feelings of well-being and
harmony, nature, security, stability and balance. It is best used for children’s learning
areas (libraries and classrooms).
Blue: Correct shade of blue is best used for welcoming area of hospitals. It slows the
pulse rate, lower body temperature, relieve headaches, migraines and muscle cramps.
Due to its soothing and calming nature, it could be used for a child’s bedroom and
bathroom.
Yellow: This colour heightens energy levels, creativity and stimulates the intellect. It
cancels out feelings of heaviness or oppression and brings feelings of warmth and joy. It
is one of the most appropriate colours for a child’s play area because of its friendly and
inviting nature. It promotes socialization among children.
It should not be used for bedrooms as it is not a very restful colour.
 • Other parameters to consider in a child’s space:

1) Anthropometrics/Scale: Equipment and facilities used in any of the spaces

should fit the child’s anthropometrics, the likes of furniture, play materials, beds,
cabinets and bathroom equipment.
2) Textures: Quite a different approach to interior design and furnishing is needed
for children facilities. The setting should promote a “kindergarten environment”,
however not at the expense of medical efficiency.
3) Finishes: Walls could be finished in claddings of soft materials like chip board
fished in bright colours of careful combination of primary colours. Floors could
be carpeted and not too slippery

 WHAT DO PEOPLE SAY?

Perspective of both user and designer should be considered while designing any
building
1. What’s your favourite part in pediatric deisgn?
2. What do you think are the complexitied of pediatric care?
3. How does the emotional journey relate with design?
4. What is the one thing in pediatric design that cannot be emphasized enough?

 DESIGNING SPACES FOR FUTURE USE IN CASE OF EMERGENCY:

The COVID-19 pandemic has turned the whole health care system upside down and
challenged everyone in the society. Being at home in fear of contact has surely changed lives
in dramatic and unexpected ways.
It became a big problem during those hard times due to lack of space in hospitals and no. of
intake count. As all the hospitals are designed only for the present situation, no one
expected these types of pandemics and did not leave space for future development.
Design and physical space plays a role in enabling disease to spread.
INTRODUCTION:
WHAT IS HOSPITAL?
A hospital is an health care institution which providing patient treatment with specialized
medical and nursing staff and medical equipment. The hospital, the major social, institution
for the delivery of the health care in the modern world, offers considerable advantages to
both patient and society. The hospital is also for centre for the training of health workers
and biosocial research. HISTORY:

 The word “HOSPITAL” ordinated from Latin word “HOSPICE”

 In early Greek and roman civilizations, the temples of gods were used as hospitals.
 The very first hospital was built by romans between 1096 and 1291. It’s a large single
room like structure, where sick or injured people used to be kept.

SITE ZONING:
FACTORS TO BE CONSIDERED IN LOCATING A HOSPITAL:
1. It should be within 15-30min travelling time, in a district with good roads and
adequate means of transport, this would mean a service zone with a radius of 25km.
2. It should be grouped with other institutional facilities, such as religious, educational,
tribal, and commercial centre.
3. It should be free from dangers of flooding.
4. It should be in an area free of population of any kind, including air, noise, water and
land pollution.
5. It must be serviced by public utilities: water, sewage and storm – water disposal,
electricity, gas and telephone. In areas where such utilities are not available,
substitutes must be found, such as a deep well for water, generators for electricity
and radio communication for telephone.
6. Hospital should be accessible from main road and secondary roads easily.
SIZE OF THE SITE:
The site must be large enough for all the planned functional requirements to be met and for
any expansion envisioned within the coming ten years. Recommended standards vary from
1.25 to 4 ha per 100 beds; the following minimum requirements have been proposed.
25-bed-capacity – 2 ha
100-bed-capacity – 4 ha
200-bed-capacity – 7 ha
300-bed-capacity – 10 ha
SELECTION OF SITE FOR HOSPITAL:

TYPES OF ENTRIES:

 Generally, there are three main entrances to the hospital that are through the
emergency entrance, second is in-patient I.P.D entry and the third is the out-patient
entry i.e. O.P.D entry.
 Besides this is the hospital has the separate service entry and the separate entry for
the administration wing.
 The main entry to the hospital is characterized by the ease in circulation, large
waiting area and the general public facilities such as ATM, phone booths, coffee
stands and the reception area etc…
SIGNAGE:

 There shall be an effective graphic system composed of a number of individual visual

aids and devices arranged to provide information, orientation, identification,
prohibition, warning and official notice considered essential to the optimum of a
hospital and other health facilities.
 All the signages in children’s hospital should be very creative thus, it should divert
them into different zones in a joyful manner rather than mood swings.

DIVISIONS IN HOSPITALS:

 Administration
 O.P.D
 I.P.D
  Emergency

ADMINISTRATION:
The administrative department is oriented to the public but is at the same time private.
Areas for business, accounting, auditing, cashiers and records, which have a functional
relationship with the public, must be located near the entrance of the hospital. Offices for
hospital management, however, can be located in more private areas.
OUT PATIENT DEPARTMENT:
Out patient department is defined as a part of the hospital, with allotted physical facilities
and medical and other staff. With regularly scheduled hours. To provide care for patients
who are not registered as in patients.
The location should be very close to the main entrance of the hospital and close to the
diagnostic services (labs and x-ray ) and close to the pharmacy.
Requirements:

 Reception and enquiry

 Waiting area
 Wheel chair and trolley bay
  Registration counter and medical record room
 Injection room
 Dressing room
 Dispensary
 Laboratory
 Radiology
IN PATIENT DEPARTMENT:
In patient department are of those patients who need treatment under helath care
personals supervision.
Patients are admitted in inpatient ward for short and long term depending upon severity of
their disease.
Requirements:

 Waiting area – 10 sqm

 Doctors room – 12 sqm
 Wards – 8 sqm/bed
 ICU – 25-35 sqm
 Common toilets – 5 sqm
 Nursing room – 12 sqm
 Treatment rooms – 20 sqm
 Storage – 20 sqm
 Mobile pharmacy – 5 sqm
EMERGENCY DEPARTMENT:
Sudden illness or injury required immediate physicians attention to prevent the danger and
delay in treatment to save the precious life with minimum disability or death.
AREA – The total internal area of the emergency department, should be at least 145 m2
(1560 ft2) for 100 bedded hospital.

EMERGENCY RECEPTION:

 Entrance + waiting area

  Registration
 Staff room
 Mini – surgery
 Rest room
 Medical utilities
 Mini sterilization room
The location should be very close to the exit door of the emergency and very close to the
radiology and close to the pharmacy, laboratories and central sterilization and direct access
to the stairs and elevators
GENERAL REQUIREMENTS:

 Entrance for patients arriving by ambulance, other modes of transportation, or

conveyances.
 Separate from main hospital entrance.
 Porch outside the lobby to protect the patients from rain & sunlight
 Approach to lobby should be in the form of ramp & steps and it should be
appropriate to usage by the disabled.
 The emergency department entrance mostly red and white sign is clearly visible.

INTERFACE WITH OTHER CLINICAL AREAS:

 The ED must have ready access to those critical care areas and diagnostic facilities
necessary for modern emergency medicine to be practices.
 Clinical areas which should be adjacent to the ED include.
 OT
 ICU
 Blood bank
 Laboratory
 OPD
 Mortuary
 Some authorities recommend a close relationship with
 CCU as well
 Many sub-depts like OT, Diagnostics etc. may be required in the department itself
LOCATION OF THE EMERGENCY DEPARTMENT:
  EDs need to be placed in an area of the hospital that is easily accessible to
emergency vehicles entering the site
 ED clinical areas should be on the ground floor
 Located adjacent to OPD.
AS PER NABH STANDARDS:
The minimum no. of beds for the hospital – 25 Nos.
Number of beds in the emergency department should be as per following criteria:

TOTAL NO. OF HOSPITAL BEDS MINIMUN BED REQUIRED IN ED

Up to 50 beds 02 beds
51 – 100 beds 04 beds
101 – 200 beds 06 beds
201 – 350 beds 08 beds
More than 350 10 beds

AMBULANCE BAY:

 The bay for 2Nos of ambulance.

CIRCULATION DETAILS:
CORRIDORS:
  Corridors provide patient, relative and staff access to all parts of the emergency
department, as well as access to service areas of the emergency department, to
storage, and access to equipment that is needed frequently or urgently.
 Clinical area – the minimum must be to allow 2 trolleys/wheel chairs to pass waily
with associated equipment e.g. a minimum width of 3m is recommended.

STAIRCASE DETAIL:

 Width of the stair & ramp is min. 1500mm

 Riser – 120mm
 Tread – 300mm

RAMP DETAIL:

 The slope ratio for the ramp is 1:10

 Width of the ramp is 1500 mm
HANDRAIL DETAIL:

 The handrails are provided where the steps & ramp used
 And also handrails are to be provide for disabled people.

STRETCHER DETAIL:

WHEEL CHAIR DETAIL:

RECEPTION AREA:

 Entrance should open in to a large open space with reception desk in front.
 It should be adjacent to triage area
 Should be close to waiting area
 Should have communication links such as telephones, worship room, grief room,
flower shop, chemist & book shop.
 Space for medico – social worker, toilets, registration & records
 BIS has recommended 1.75 Sqm per hospital bed for the reception area

WAITING SPACE:

 Should provide sufficient & comfortable space for waiting patients & relatives
 Area should be easily observed from reception
 Should be appropriately furnished with visual displays on health education &
hospital related information
 Should cater for facilities such as drinking water, ladies & gents toilets, television &
channel music
 The space should be facilitate with toilets.
 Seating for parents and children should be provided accordingly
 Few play areas also to be provided to engage children while waiting.
DESKTOP CASE STUDIES
CASE STUDIES OUTLINES
1. Borne Riget : analysis about form, program, circulation, façade and material
2. Suzhou : analysis about circulation
3. Ekachai : analysis about circulation and children scale

BørneRiget | Copenhagen Children’s Hospital

Project Information

Architect : 3XN Architect

Location : Copenhagen, Denmark
Floor Area : 58,600 m²
Storey - Building : 9storeys
Hospital Bed Number :210beds
Staff Member : 1050 members

Site location

Design concept

The New Children's Hospital (BørneRiget) with a ‘Playfully Logical’ design takes its point of
departure in two hands that stretch their ‘fingers’ into the light, into the city and into the green. Two
hands that complement each other, just like the two halves of the brain. The left and right hands are
connected to each hemisphere representing the creative play and the rational logic.
 Figure 5.1 Concept Diagram
Design principles
Based on the vision applying to the building project, an innovation process has been defined in a
close collaboration between patients, families, managers and staff. This design principles are to combine
both the organization and the building facilities.

The are 5 design principles as following:

Integrated Play Designed for Daily Living See me, ask me, Let me

Good Journey
Cleanly defined zone

Figure 5.2 Design Principles Diagram

Children's experience is very important. Their feeling of being able to take control of their own situation
can reduce their stress. And at the same time, their need to be seen and safe.
 Figure 5.3 Daylight on Building

The facade gives the hospital 100% facing ity as well as optimal conditions (Figure 5.3). The form of
building makes its view and connection towards the city. The space between the fingers make all the
bedrooms receive a different view of the city (Figure 5.4).

Figure 5.4 View and Connection to the City

Fingertips
There are different functions that are provided at each fingertip. Especially an outdoor garden and
playing area with diverse themes. The outdoors space will adapt and have a different function according
to the weather. Thus, children can come to play and learn at the fingertip and receive a good
experience
 Figure 5.5 Fingertips Programming
Facade and function

The design focuses on ensuring a good thermal indoor climate. To reduce risk of cold from the
double-height glass sections and too low temperatures in winter, low-energy windows can be used
instead of single-layer glass. In the summer, there can controlled natural ventilation, sun protection to
the south, east and west and focus on. 25% of the year's facade will be closed because of the cold
winter. While in the summer, the facade can be adjusted in order to protect the sun shade and let the
wind flow in the same times.

Figure 5.5 Facade Opening Diagram

Programming and circulation

The main circulation for visitors are stairs and elevators at the center of the building. Ward will be
located at the top while the clinic will be located at the bottom. In the middle of the builder, there are
the operation area and academics.

Elevator

Main
Circulation
Stair

Service Area

Figure 5.6 Connection Circulation between Level and Programming on Each Floor
Intensive care, surgery, diagnostics, delivery and outpatient clinics are located in the lower floor. The
connection of each finger will provide more space and ease for staff circulation. The fingers as figure
5.6 are located on the 5th-8th floor where children's wards take place. At the same time, the sequence
of the hospital is similar to their home.

Figure 5.6 Clear zones - Individual hierarchy between private and public areas.

Figure 5.6 Clear zones - treatment floor

Figure 5.7 Zoning Relationship

 Figure 5.8 Distances

From the core of the building to the tip of each figure are not more than 35 m. The public space is
located at the center and more private where bedrooms are located at the tip of the finger. Thus, the
bedroom will receive less noise than other zones in the center (figure 5.9)

Figure 5.9 Private Vs Public

There are more than one entrance on the first floor. The staff entrances are located on the site of the
building.
 Figure 5.10 Site Plan Circulation

1. Ambulance Ramp 8. Training and Rehabilitation

2. Residence Garden 9. Born and Kid Clinic
3. Adult Outpatient Clinic 10. Day Hospital
4. Reception 11. Atrium/Garden
5. Play Area 12. Meeting Point
6. Outdoor Seating 13. Supermarket
7. Frontcourt 14. Cafe

Staff Entrance
Patient FLow
 Figure 5.11 3rd Floor Plan Circulation

Patient Flow Elevator Service Lift

Figure 5.12 Section, BørneRiget

 Figure 5.13 Elevation, BørneRiget
Sections are cut through main circulation. The stairs at the center provide ventilation for the building.
The fire stairs are located in every finger for safety. Elevators are attracted by colorful fades and
surrounded by green with different rhythms. The up and down of the building make it fun and
moveable.

Material
The building is characterized by spaces and experiences that speak to everyone. At the same place,
furniture or artwork can easily be exciting for both the little ones and the old. It is about creating layer
shades through playful materials, color and surface.
Thus, using different materials can catch children's interest and create learning skills.

golden wood natural rubber wild nature rock anodise Ren aluminium

Figure 5.14 Durable, Natural and Tactile Choices

Surface Plasterboard, Air Verify Antibacterial curtains

Figure 5.14 Healthy, smart and active surfaces

Figure 5.15 Material Indoor Diagram

Ekachai | Children’s Hospital
Project information
Architect : IF (Integrated Field)
Location : SamutSakorn, Thailand
Floor Area : 7,200 m²
Storey-Building :5storeys
Hospital Bed Number : 54 beds
Daily Outpatient Visit : 75

Design concept
Design Philosophy: Playing is Healing. Key Concept :
‘Children Dimension’.

1. wooden decoration
2. Curved Lines
3. children scale

Figure 5.23 Interior Perspective, Waiting Area, EKH Children’s Hospital

Figure 5.23 shows dimension concept which scales down many things to better fit the children. For
example, the wood decorations curving along the walls are at one meter level, at their average eye
level. These curved lines are hand drawn and not geometrically perfect as the designers believe they
can better stir the children’s imagination. Also, the cashier counters are curved down to enhance
more interaction between the nurses and the children.

The design of 60 rooms is highlighted by four constellations—whale, rabbit, turtle and lion on the
illuminated ceilings. These animal patterns are also in the perforated steel plates on the building’s
exterior. A variety of colors inside the rooms can also be seen on the room doors. They use bright
colors in children’s space design because children make use of color contrasts in their visual
comprehension.

Figure 5.24 Interior Perspective, Bedroom, EKH Children’s Hospital

Figure 5.25 Interior Perspective, Bedroom (at night), EKH Children’s Hospital
With children’s mindset, design approach of EKH CHILDREN HOSPITAL is to make the project a
‘fun’ place by incorporating many components of playground design. We use many elements as giant
slider situated right at the front of the entrance hall, transforming waiting area of each clinic into a
playground, indoor swimming pool with bunch of artificial clouds floating atop.

For kids, luxury isn’t something that can comfort them from the pain, fear for needles or even the
bitterness of the medicine. Therefore, look for the things that will bring them happiness throughout
their experience at the hospital. With the children’s mindset, we discover that ‘fun’ is what every
child instinctively looks for. Despite their different backgrounds, all kids want to live their lives
looking for something fun to do.
Such thought process leads to the design of a hospital with a gaint slider situated right at the front of
the entrance hall (imagine being a kid dreading going into the hospital, the slider will definetily make
you stop crying). The waiting area of each clinic is designed into a playground, which becomes some
what burden for the parents of having to convince the kids to leave the hospital. The program also
includes an indoor swimming pool that has a bunch of artificial clouds floating atop.
Programming and circulation
The diagram shows analysis of the patient and staff circulation. Also the program on each floor.
 Figure 5.26 First Floor Plan, EKH Children’s Hospital

Figure 5.27 Second Floor Plan, EKH Children’s Hospital

 Figure 5.28 Third Floor Plan, EKH Children’s Hospital

Figure 5.29 Fourth and Fifth Floor Plan, EKH Children’s Hospital
Room plans

Façade
Figure 5.30 shows the facade of the building using pastel color in order to make it easy for the eye
and friendly with the surrounding context. They use curves at the entrance to welcome children.

Figure 5.30 Elevation, EKH Children’s Hospital

CASE STUDIES
CASE STUDIES OUTLINES
1. Rainbow hospitals – Banjara Hills – analysis of concepts & children psychology
2. Ankura hospitals – Miyapur – analysis about scale of site and circulation

CASE STUDY 1: RAINBOW HOSPITALS, BANJARAHILLS, HYDERABAD.

Site location
The 205 bed capacity child health department of the rainbow hospital is one of the largest patronized
and best staffed children’s hospital is located in banjara hills, Hyderabad, the capital town of
Telangana. This hospital is located next to the accident and emergency unit.
Floor area – 14600 square meters.

Reasons for study

 It is the best children’s hospital in this city
 Its spatial organization which is based on standard paediatric centre design is worth studying
with the modern facilities, equipment and services used in the hospital is worth studying
 Study of Spatial organisation of different departments in a rectangular space in different
levels is worth studying
 Usage of different colours textures and creative interiors are best

Composition
 The whole building is divided into 3 zones at each level i.e., A-zone, B-zone, C-zone.
 This building is of 1 basement, 1 lower ground floor, G+5 floors.
 A-zone has 2 lifts (1 bed lift and 1 passenger lift), B-zone has 2 lifts(1 bed lift and 1
passenger lift), C zone has 1staff lift
 1. Lower ground floor
This floor consists of 3 zones - A,B,C zones
A-zone contains the neurological department, billing counter, emergency ward, consultation rooms,
physiotherapy.
B-zone contains the gynaecology department, OPD, pharmacy, administration, emergency entry bay.
C-zone contains the cafeteria, X-ray, MRI scan room, counselling room

2. Ground floor
A-zone contains the help desk, play area, lobby, registration & billing OP, feeding room, reception,
consultation rooms.
B-zone contains the reception, vaccination room, X-ray, fluoroscopy, consultation rooms, electrical
rooms and Dental department
C-zone contains the kitchen, utility and cafeteria

3. First floor
A-zone contains the blood donation room, storage room, screening room and different labs.
B-zone contains the oncology ward, bone marrow transplant unit, semi private rooms, 2 general wards
of 4-6 sharing beds, 2-4 sharing wards.
C-zone contains the day care rooms with 3 sharing beds.
 4. Second floor
A-zone contains the PICU department.
B-zone contains the sharing wards of 2 beds, semi-private rooms of 2 sharing beds, bio – medical
room.
C-zone contains the NICU department, doctors room, family centric ICU.

5. Third floor
A-zone consists of 23 private rooms (deluxe rooms)
B-zone consists of super deluxe rooms.
C-zone consists of suite rooms.

6. Fourth floor
A-zone consists of 4 paediatric OT, storage rooms and medicine supply room.
B-zone consists of labour rooms – 2 normal delivery, 2 OT, pre OT, OBG OT
C-zone consists of 5 presidential suites and 1 normal delivery OT
 7. Fifth floor
All zones consist of administration offices and storage rooms

Structure and building form

 The solar panel heat pump hybrid system installed in the facility is projected to meet at least
60 percent of the building’s hot water demand, contributing to the reduction in energy.
 A black water treatment and recycling system is expected to reduce water use nearly in half.
 Embodied energy in materials will be reduced by 42 percent because of construction materials
like autoclaved aerated concrete blocks for the hospital’s walls.
 Rainbow Children’s Hospital – Banjara Hills has received final EDGE certification from
GBCI.

Building orientation, Natural ventilation and lighting

 Entire building is constructed as a single block.
 The hospital is south facing building and is facing the road.
 All the 3 sides are covered with low height buildings with small amount of vegetation which
gives good air circulation around the building.
 The longer sides facing east-west direction, while the shorter sides facing north-south
directions.
 All the rooms facing east and west gets good morning sun light and evening sunset
 Usage of long and wide windows in the walls allows the penetration of daylight and
ventilation.
 This hospital doesn’t have any verandas or any open areas or gardens for good air flow and
ventilation.
Circulation systems
A. Horizontal circulation system:
 Lobbies and corridors are the main horizontal circulation systems used.
 Main corridors for circulation in the wards are about 2.4M and the minor corridors are about
2M.
B. Vertical circulation system:
 Staircases, lifts and ramps are main types of vertical circulation systems used.
 2 emergency exit staircase are used, 2 passenger lifts, 2 bed lifts and 1 staff lift are used.
 The width of ramp is 2.4M which has 1:12 ratio.

Bed lift and passenger lift

Staircase
Ramp

Interiors
All the walls and ceilings are painted with calm and neat colours with different concepts at each floor
and at each department.
Several brightly coloured drawings, wall hangings and paintings on the walls make the spaces more
child-friendly
Services
Well designed service ducts carry service pipes through the various floors of the building.
Fire fighting mechanisms such as fire extinguishers are also used in the building.

Programming and circulation

Merits and Demerits

Merits:
a. In-patient activities have been separated from out-patient activities
b. Every department has its own privacy without any circulation problem
c. Paintings and drawings on walls suggest a child-friendly environment.
d. All the rooms have good ventilation through large windows.
e. Every zone has its own lifts and staircase for ease circulation
f. All the walls in the hospital are coloured with child-friendly colours.
Demerits:
a. Location of the hospital is not too close to accident prone area.
b. There is no natural ventilation coming into the hospital
c. The way to parking and emergency ward are same which is causing heavy vehicular traffic
near emergency entrance which is a risk in emergency time
d. As the building is very long and narrow, we should pass a long way to enter different
departments.
e. Lack of outdoor play area or gardening in the hospital
f. All the private rooms are completely packed without any good view which make children feel
anxiety
g. Lack of interactive areas for kids.
h. It doesn’t have proper set backs and turning radius for the entry of fire extinguishers and
spacious 2 way for ambulance and cars .

Spatial disposition:
Total floor area of the hospital – 2500 square meter
Set backs of the site – 5M
Ceiling heights – 2.4M

Fenestrations (doors and windows)

The use of long and wide windows allows maximum flow of air and good penetration of daylight
Dimensions

Lighting and colour schemes

Lack of natural light in the hospital, artificial lights are used every where, artificial light is preferred
all over the hospital with high luminance levels.
Down lights, recessed lights and cove lights are used.
Special lights are used in operation theatres as preferred.

Floor finish:
2’x 2’ semi-polished ceramic tiles are used as floor finish. Tiles are washable and dry faster after
cleaning.

Partitions:
Glass partitions are used in NICU, ICU for privacy and also for better interaction between children to
make them forget their loneliness.
Specially designed and polished wooden board with glass, about 2.8M is used for partitioning the
space. These partitions facilitate easy supervision in the wards.
Emergency entrance:
The area of the emergency entrance is 24’x64’ where 3 ambulances can fit at a time.