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Functional program
Steps in programming individual departments
or services
Step 1 - Decide General Policies
Step 2 - Determining Rooms
Step 3 - Determining Relationships
Step 4 - Determining the Design Criteria for Each Room
Step 5 - Determine Special Requirements for Each Room
Partial list of suggested services to be
considered
Partial list of various systems to be considered
Functional Program
Many differences exist among populations utilizing the services of
licensed care facilities. These differences include the physical, social,
and health care utilization patterns and needs of the users. Therefore,
broad ranges of operational and physical factors should be considered when
planning operational components of any facility regardless of size, type,
or location. The universal questions to be answered are who, what, when,
where, why and how. The following components will answer these questions,
and should be addressed in a functional program:
- The scope of the project, providing background information.
- Space requirements and functions to be performed.
- Relevant material from the Certificate of Need application.
- Specific departments, services, and systems as related to services to be provided.
- Departmental location and grouping of departments considering
logistics and traffic patterns.
- Organization and staffing to include workload and workflow.
- Tasks and processes which require special planning and the use of
equipment.
- Mechanical and electrical requirements, communications, and
transportation.
- Environmental relationships and future proposed changes.
Steps in Programming Individual Departments or
Services
In the initial general programming for a facility, broad decisions as
to the extent of services and the mode of operation will be made. These
broad decisions, which are made for the facility as a whole, form the
basis for the detailed planning of every service and service area. If so
planned, a well-coordinated and efficient facility will result. The
following steps are suggested as an approach to programming individual
service areas:
Step 1
Review functions and decide the general policies and
procedures for the operation of the service area.
This can be done by deciding:
- For what functions provisions should be made in the service area.
- How each function is to be carried out.
- Who will be responsible for each function.
- What types of equipment, furniture, etc., will be needed to
carry out each service.
In some instances, the general policies and procedures for a service area
may not differ from those for the facility as a whole. For example, it may
have been previously decided that linens will be stored on the carts and
delivered to the various service areas, and no fixed shelves are needed.
Therefore, it may not be necessary to further refine the plan for storing
and distributing linen. Instead, the size of the cart needed, the clean
room/area where linens are to be stored, within the service area, should
be addressed.
On the other hand, there are many instances in which further
determination of policies and procedures are necessary. For example, in a
hospital it may have been decided that all preparation of surgical and
obstetrical supplies and equipment will be carried out in the Central
Service. In the planning of the surgery suite, there is need for
formulating policies and procedures for collecting and sending supplies
and equipment to Central Service, and for storing clean supplies and
equipment within the surgery and obstetrical services. These policies and
procedures will dictate the space and equipment required.
Step 2
Determine the rooms or separate work areas that are needed.
The numbers and types of rooms should be determined through study of
the functions and the policies and procedures, which have been formulated
in Step 1. Functions may be grouped together according to their logical
relationship. The following groupings may indicate which functions may be
carried out in the same rooms and which functions should be in separate
rooms:
- Technique.
- Volume of work.
- Best work flow.
- Personnel who will be responsible for each function.
- Possibilities of certain equipment serving more than one function.
Step 3
Determine relationships.
Decide how the various rooms and areas within the service area should
be located in relation to one another. Logical traffic and work flow
should be determining factors in deciding which rooms should be adjacent
and which should be located in specific areas. It may not be possible to
achieve architecturally ideal relationships so it would be best to
indicate the most important items for the architect to give preference.
Step 4
Determine the design criteria for each room or area.
This final step in programming requires a detailed study of work
organization within each room. The following steps are suggested as a
means of programming the requirements for each room:
- List the functions to be carried out in the room.
- Study activities and determine workstations.
- Determine the activities or subdivisions of work that are necessary
to accomplish each function that is to be carried out in the room.
- Decide which of these activities may be handled at the same
workstation and which will require separate workstations.
- Determine the equipment for each workstation. The listing of
equipment required at each work station should include:
- Fixed equipment such as work counters, cabinets, sinks, bulletin
boards, and other stationary equipment.
- Mobile or portable equipment, which will be kept or used within
the room. It is important the architect have an understanding of
the mobile equipment so he can provide space for it to be
conveniently located in the work area in which it is to be used.
Otherwise such equipment may block workspace or traffic and
interfere with efficient functioning of the room. Even a waste
receptacle or a laundry hamper can present a problem if there is
no space to properly locate it.
- Decide upon working relationships within the room. The use of work
flow charts can be very helpful in determining these relationships.
- Decide how the different workstations in the room should be located
in relation to one another. Can they be adjoining or should they have
a definite physical separation? Is there any equipment which will
serve more than one workstation and should it be located between
workstations?
- Decide how the different items of equipment within each workstation
should be located in relation to one another. For example: Should a
sink be located at the end of a work counter or in the middle of a
work counter?
Step 5
Determine other special requirements for the room. Items that might
require special consideration include:
- Special plumbing requirements
- Oxygen outlets
- Vacuum outlets
- Compressed air outlets
- Gas outlets
- Waste gas evacuation system
- Special lighting
- Electrical outlets
- Ventilation
- Communications
- Finishes
- Entry and exit requirements
- Special design requirements
It is important to note where special features in equipment are necessary
for proper work conditions. For example: In some areas, such as hospital
Central Service and the Laboratory where personnel do considerable work in
a sitting position, it is important to provide a proper knee space or
footrest. In some areas it may be desirable to design so that personnel
have the opportunity of alternating between standing and sitting to avoid
undue fatigue. In some areas it may be desirable to have work counters at
a height that is not generally considered standard.
Partial list of suggested services to be
considered:
Lobby, administrative offices, business and accounting facilities,
personnel department, admitting, switchboard, reception.
Communications, supplies, stores, laundry, plant engineering and
maintenance, housekeeping, materials management, dietary, central
services.
Pharmacy, medication distribution, medical records, social services,
spiritual services.
- Nursing and Medical Services
Utility rooms, exam rooms, diagnostic & treatment rooms, and
specialized medical procedure rooms.
Patients/Residents and their families’ education; In-service staff
training and continuing education; and staff meetings.
Auxiliary functions such as gift shop, meetings, conference rooms, beauty
salons, and libraries, etc.
Partial list of various systems to be
considered:
- Air - Conditioning (cooling, heating, ventilating)
- Air - Mechanical, compressors
- Air - Medical, separate system
- Alarm system for these gasses.
- Cardiac Code Call
- Communication Systems, including computers
- Compressed Gases (nitrogen, nitrous oxide, oxygen)
- Disaster
- Domestic water supply (hot, cold, storage)
- Electrical system including emergency electrical service
- Emergency Call Systems
- Emergency Entrance Night/door locked call
- Graphics and Signage
- Handicapped Accessibility
- Heating fuel
- Infection Control
- Life Safety (entry/exit, compartmentalization for smoke and fire,
fire sprinkler system and fire alarm system)
- Linen System (clean, soiled, contaminated)
- Mail System
- Maintenance
- Medical Emergency Assistance
- Nurse Call System (patient bedside and toilet/bathing facility)
- Nurse Locator System
- Physician Register System
- Pneumatic Tube or Tote System
- Public Address (paging) System
- Radio
- Radioactive Materials Handling System
- Security (patient, staff, and facility)
- Sewer system
- Supply System
- Telephone system
- Television System
- Utilities, e.g.
- Vacuum System
- Waste Gas Evacuation
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