# Healthcare Facility Design

## Facility Types

### Outpatient
| Type | Typical Size | Description |
|------|--------------|-------------|
| Medical office | 2,000-20,000 SF | General practice |
| Specialty clinic | 3,000-30,000 SF | Single specialty |
| Multi-specialty | 15,000-75,000 SF | Multiple practices |
| Urgent care | 2,500-5,000 SF | Walk-in treatment |
| Surgery center (ASC) | 8,000-30,000 SF | Same-day surgery |
| Imaging center | 3,000-15,000 SF | Diagnostic imaging |
| Dialysis | 8,000-15,000 SF | Renal treatment |

### Inpatient
| Type | Description |
|------|-------------|
| Critical Access Hospital | < 25 beds, rural |
| Community Hospital | 25-150 beds |
| Regional Hospital | 150-400 beds |
| Academic Medical Center | 400+ beds, teaching |
| Specialty Hospital | Single focus (ortho, cardiac) |

---

## Exam Room Standards

### Exam Room Sizes
| Type | Size | Clear Area |
|------|------|------------|
| Standard exam | 100-120 SF | 80 SF clear |
| Large/bariatric | 140-160 SF | 100 SF clear |
| Procedure room | 180-250 SF | 150 SF clear |
| Consultation | 100-120 SF | - |

### Exam Room Layout
| Element | Dimension |
|---------|-----------|
| Exam table space | 7'-0" × 3'-6" clear |
| Patient chair | 3'-0" × 3'-0" |
| Physician work | 4'-0" × 3'-0" |
| Sink counter | 4'-0" × 2'-0" |
| Door swing | Into room or out |

### Exam Room Components
| Required | Optional |
|----------|----------|
| Exam table | Procedure light |
| Sink | Wall-mounted diagnostics |
| Counter/cabinets | Refrigerator |
| Chair (patient) | Scale |
| Stool (physician) | Sharps container |
| Waste receptacle | Computer/workstation |

### Exam Room Clearances
| Activity | Space |
|----------|-------|
| Patient transfer | 36" clear at table |
| Wheelchair | 60" turning radius |
| Stretcher access | 44" clear path |
| Equipment access | 36" minimum |

---

## Treatment and Procedure

### Procedure Room Types
| Type | Size | Use |
|------|------|-----|
| Minor procedure | 180-220 SF | Sutures, biopsies |
| Major procedure | 250-350 SF | Complex procedures |
| Imaging (X-ray) | 200-250 SF | General radiography |
| CT scan | 450-550 SF | Computed tomography |
| MRI | 600-800 SF | Magnetic resonance |
| Ultrasound | 140-180 SF | Sonography |

### Operating Room Sizes
| Type | Minimum Size |
|------|--------------|
| Class A (minor) | 250 SF |
| Class B (general) | 400 SF |
| Class C (major) | 600 SF |
| Cardiac/neuro | 600-800 SF |
| Hybrid OR | 1,000+ SF |

### OR Requirements
| Feature | Requirement |
|---------|-------------|
| Ceiling height | 10'-0" minimum |
| Lighting | 2,000+ FC surgical |
| Temperature | 62-68°F |
| Humidity | 30-60% RH |
| Air changes | 20 ACH minimum |
| Pressure | Positive to corridor |

---

## Patient Rooms

### Patient Room Types
| Type | Size | Description |
|------|------|-------------|
| Semi-private | 200 SF/bed | 2 beds, shared |
| Private (standard) | 250-300 SF | 1 bed |
| Acuity-adaptable | 300-350 SF | ICU convertible |
| ICU | 350-450 SF | Critical care |
| Bariatric | 400-500 SF | Oversized |

### Patient Room Zones
| Zone | Description |
|------|-------------|
| Patient zone | Bed, headwall, equipment |
| Family zone | Seating, storage |
| Staff zone | Charting, supplies |
| Bathroom | Toilet, shower |

### Headwall Requirements
| Component | Requirement |
|------------|-------------|
| Medical gases | O2, vacuum, air (varies) |
| Electrical | 6-12 outlets |
| Data | 2-4 ports |
| Nurse call | At bed, in bathroom |
| Lighting | Exam, ambient, night |

### Patient Bathroom
| Feature | Requirement |
|---------|-------------|
| Size | 50-80 SF minimum |
| Door | 44" clear |
| Toilet clearance | 60" turning radius |
| Shower | Roll-in, folding seat |
| Grab bars | At toilet and shower |
| Nurse call | At toilet and shower |

---

## Circulation

### Corridor Widths
| Type | Minimum | Preferred |
|------|---------|-----------|
| Main public | 8'-0" | 10'-0" |
| Inpatient | 8'-0" | 8'-0" |
| Service | 6'-0" | 8'-0" |
| Staff-only | 5'-0" | 6'-0" |
| OR suite | 8'-0" | 10'-0" |

### Circulation Separation
| Flow | Requirement |
|------|-------------|
| Public | Separate from clinical |
| Patient | Semi-restricted |
| Staff | Restricted access |
| Clean supplies | Separate from soiled |
| Soiled/waste | Isolated path |

### Elevator Requirements
| Type | Use |
|------|-----|
| Public | Visitors |
| Patient/bed | Stretcher transport |
| Service | Supplies, equipment |
| Staff-only | Quick vertical transport |

### Elevator Sizing
| Type | Size |
|------|------|
| Passenger | 3,500-4,000 lb |
| Bed/stretcher | 4,500-5,000 lb |
| Service | 4,000-5,000 lb |
| Minimum cab depth | 84" (stretcher) |

---

## Support Spaces

### Nursing Stations
| Type | Size | Use |
|------|------|-----|
| Centralized | 200-400 SF | Traditional hub |
| Decentralized | 40-60 SF each | Near patient rooms |
| Alcove | 20-30 SF | Just outside room |

### Medication Room
| Feature | Requirement |
|---------|-------------|
| Size | 60-100 SF |
| Counter | 6 LF minimum |
| Refrigerator | Locked, monitored |
| ADC (automated) | 40 SF each |
| Sink | Handwash |
| Access | Restricted |

### Soiled Utility
| Feature | Requirement |
|---------|-------------|
| Size | 80-120 SF |
| Sink | Clinical service |
| Hopper | Bedpan disposal |
| Waste | Red bag, sharps |
| Negative pressure | To corridor |

### Clean Supply
| Feature | Requirement |
|---------|-------------|
| Size | 80-150 SF |
| Shelving | Open wire |
| Linen | Covered cart or room |
| Positive pressure | To corridor |

---

## Diagnostic Imaging

### Room Sizes
| Modality | Room Size | Control Area |
|----------|-----------|--------------|
| General X-ray | 200-250 SF | 60-80 SF |
| Fluoroscopy | 300-350 SF | 80-100 SF |
| CT | 450-550 SF | 100-150 SF |
| MRI | 600-800 SF | 150-200 SF |
| Ultrasound | 140-180 SF | In room |
| Mammography | 140-160 SF | In room |
| Nuclear medicine | 180-220 SF | 80-100 SF |

### Shielding Requirements
| Modality | Shielding |
|----------|-----------|
| X-ray | Lead-lined walls, door |
| CT | Lead-lined walls, door |
| MRI | RF shielding (copper) |
| Nuclear | Lead-lined, depends on isotope |

### MRI Special Requirements
| Requirement | Description |
|-------------|-------------|
| 5-gauss line | Safety perimeter |
| RF shielding | Copper mesh or plate |
| Helium vent | For quench |
| No ferrous metal | Strict control |
| Weight | 10,000-20,000 lb |

---

## Infection Control

### Airborne Infection Isolation (AII)
| Feature | Requirement |
|---------|-------------|
| Pressure | Negative to corridor |
| Air changes | 12 ACH minimum |
| Exhaust | Direct to exterior |
| Anteroom | Recommended |
| Monitor | Pressure differential |

### Protective Environment (PE)
| Feature | Requirement |
|---------|-------------|
| Pressure | Positive to corridor |
| Air changes | 12 ACH minimum |
| Filtration | HEPA supply |
| Use | Immunocompromised |

### Hand Hygiene
| Location | Requirement |
|----------|-------------|
| Exam rooms | Sink or dispenser |
| Patient rooms | In room and bathroom |
| Corridors | At intervals |
| Entries | Dispensers visible |

---

## Regulatory Requirements

### FGI Guidelines
| Area | Reference |
|------|-----------|
| Hospital | FGI 2022 Hospital |
| Outpatient | FGI 2022 Outpatient |
| Residential | FGI 2022 Residential |

### Space Requirements by FGI
| Space | Hospital | Outpatient |
|-------|----------|------------|
| Exam room | 100 SF | 100 SF |
| Toilet room | 35 SF | 35 SF |
| Clean utility | 80 SF | 60 SF |
| Soiled utility | 80 SF | 60 SF |

### Accreditation
| Body | Focus |
|------|-------|
| Joint Commission | General accreditation |
| AAAHC | Ambulatory surgery |
| AABB | Blood bank |
| CAP | Laboratory |
| ACR | Imaging |

---

## Wayfinding

### Signage Strategy
| Level | Function |
|-------|----------|
| Building | Department location |
| Floor | Service location |
| Room | Identification |
| Regulatory | Safety, accessibility |

### Color Coding
| Department | Common Color |
|------------|--------------|
| Emergency | Red |
| Surgery | Green |
| Imaging | Blue |
| Laboratory | Yellow |
| Administration | Gray |

---

## Parking and Site

### Parking Requirements
| Use | Ratio |
|-----|-------|
| Hospital | 3-4 spaces/bed |
| Medical office | 5-6 spaces/1,000 SF |
| Outpatient surgery | 3-4 spaces/OR |
| Emergency | Dedicated + drop-off |

### Entry Types
| Entry | Function |
|-------|----------|
| Main entrance | Lobby, registration |
| Emergency | Ambulance, walk-in |
| Service | Deliveries, loading |
| Staff | Secure access |

### Ambulance Access
| Feature | Requirement |
|---------|-------------|
| Bay size | 12' × 40' per |
| Canopy | Covered |
| Height | 14'-0" clear |
| Doors | Automatic, oversized |
| Proximity | Direct to trauma |

---

## Special Systems

### Medical Gas
| Gas | Symbol | Use |
|-----|--------|-----|
| Oxygen | O2 | Respiratory |
| Medical air | MA | Ventilators |
| Vacuum | VAC | Suction |
| Nitrogen | N2 | Surgical tools |
| Nitrous oxide | N2O | Anesthesia |

### Nurse Call
| Feature | Requirement |
|---------|-------------|
| Patient station | At bed, in bathroom |
| Staff station | Corridor, nursing |
| Code blue | Emergency alert |
| Integration | With phones, displays |

### IT Infrastructure
| Feature | Requirement |
|---------|-------------|
| Data density | High (many devices) |
| Wireless | Full coverage |
| RTLS | Real-time location |
| Integration | EMR, building systems |
