Health Care Facility Layout

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CHAPTER FIVE

FACILITY LAYOUT

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henever an existing facility is renovated or a new facility designed, the chance exists to develop a layout that will improve process flow and minimize wasted space. When a new facility is designed, the facility layout should be integrated into the architectural design. Limitations on building lot size and shape, however, may heavily influence the layout configurations available. In other situations, a new layout is achieved simply by renovating an existing area, in which case the size and shape of the area are set, and the limitations relate to the funds available. Planning facility layout is important for many reasons. The amount of capital invested in new construction or renovation is usually substantial. The results are long-term: while minor modifications may be possible, the overall layout will last well into the future. Furthermore, layout has an enormous effect on daily operations. Not only does layout dictate the distance a patient must travel from one department to another; it also influences which staff members are likely to interact and communicate. The basic goals in developing a facility layout should be functionality and cost savings. Functionality includes placing the necessary departments, such as the operating and recovery rooms, close together. Functionality also includes keeping apart those departments which should not be together. Overall, functionality includes aspects of a layout which may not be immediately quantifiable, such as facilitating communication and improving staff morale.

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Facility Layout

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Cost savings include reduction in travel times between areas, reduced construction costs by minimizing the space required, and allowing for reduced staffing by placing similar job functions close together. Two key elements of these goals are saving space and reducing the travel distance and time between departments. The amount of space allocated to a given department often is set by factors beyond the control of the facility planner, whose job it then is to make the most of that space. A poorly designed workspace harms both productivity and quality. Another aspect, the travel distance between departments, is a cost that can reach enormous proportions long-term. What may seem a short walk to a designer may add up, over the life of a facility, to days lost to travel. That not only adds to costs, but also weakens staff morale. Facility layout is a complex process with many variables. Given unlimited time, space, and funding, it would be possible to develop and create the optimal layout. Given the constraints on any project, though, layout planning should still provide the best layout possible in any situation—one that can save money, improve the quality of care, and/or improve staff morale. A good layout will draw on the experiences of the planner, the technical knowledge of the staff who will be using the facility, a strong understanding of how to minimize wasted space and movement, and the forecasts of future needs. Although a planner usually acquires most of these skills, certain technical knowledge of a field is something the facility layout planner may never acquire. A strong understanding of the tools to minimize wasted space and movement, however, is readily taught and provides a good background from which to begin a facility layout (Stevenson, 2002; p. 232). The three basic types of layouts are the product layout, the process layout, and the fixed-position layout. These layouts may be applied to either a single department or an entire facility (group of departments). Therefore the elements of the layout may be either whole departments or individual pieces of equipment (hospital beds, cafeteria equipment). An actual facility layout is almost always a mixture of the three basic types. A hospital may have an overall process layout as all the departments are grouped (intensive care, nursing units, administration). At the department level, there may...
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