510
Generalized Needs and Requirements: Hospital Requirements
Recently, other configurations have been put forth. Foremost among
these are: (1) the nursing "tower" adjacent to a non-nursing "base"
(articulated tower), (2) nursing units and non-nursing functions
interspersed on each floor (low block, pavilion or high block), and (3) a
nursing tower adjacent to separate industrial and medical support units
(articulated tower). These options are discussed more fully in Section
250.
The four organization options described above represent basic types.
Undoubtedly, there are others, each type has hundreds of variations
developed in response to site conditions, the constraints of existing related
buildings, variations in administrative policy, etc. With this variety, it is
clearly impractical to define a rigid hospital organization around which a
building system could be developed. In certain cases, it may be possible
to identify configurations which optimize medical or operational efficiency.
History indicates, however, that operational factors which generate
"optimum" solutions change in time, and a different "optimum' is created.
The building system will remain a valid, self-improving system only so long
as it can accommodate all "optimum" options proposed.
513.4.2
Relationship Between Functional Units
1. The building system, should be capable of accommodating a wide
range of operational patterns.
Relationships within the hospital are determined by both operational
and physical requirements.
The operational relationships which most affect configuration are those
of transportation or movement. These may be categorized as (1)
patient movement, (2) staff movement, and (3) material movement.
Each category must be evaluated in terms of (a) the characteristics of
the object being moved, (b) the frequency of movement, and (c) the
urgency of movement. Materials handling systems are closely
interrelated with the organization of distribution and receiving stations
and the type of movement equipment provided. A highly mechanized
distribution system may allow relationships which would be undesirable
in a hospital with manual distribution systems. Or, a highly organized
and compact "vertical" hospital may be optimum for patterns of
distribution and equipment which would be quite inefficient for a
"horizontal" hospital. No one pattern can fit all circumstances.
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