This document discusses international healthcare building standards and codes, with a focus on comparing and harmonizing standards from the AIA, NHS, DIN, and other sources. It begins with a comparison of standards between the AIA, NHS, and DIN for operating theatre and patient room door sizes. Case studies examine projects planned according to AIA standards but not acceptable per NHS standards, and a project undergoing third party review. Standards from HAAD Abu Dhabi are discussed, which are based primarily on Australian guidelines. There is no recommendation made for a single standard to follow, as customer requirements can vary, but standards provide good guidelines while also requiring flexibility. The presentation concludes with a question and answer section.

1. 1
Hospital Planning and Building Standards – AIA, NHS, DIN
INTERNATIONAL HEALTHCARE BUILDING STANDARDS &
CODES – LATEST ON HARMONIZATION OF CODES AND
ACCREDITATION
HENNING LENSCH, RRP International Hospital Planners Pte Ltd
Munich-Germany-Singapore
September 2013
Toronto UIA 2013

2. 2
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1. Comparison of AIA, NHS and DIN
2. Case Study 1: planned in accordance with AIA, not acceptable for NHS?
3. Case Study 2: Third Party Review and standards – please re-design?
4. Accreditation and Planning Standards – JCI instead of AIA/NHS/DIN
5. HAAD Abu Dhabi standards, based on Australia hospital standards
6. Outlook and recommendation – what to follow?
7. Question and Answers
Agenda

3. 3
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1. Comparison between AIA, NHS and German DIN
Agenda

4. 4
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AUS SICHT DES KRANKENHAUSES
What is the standard OT seize?
International projects, state of the art?

5. 5
1. Standards for hospital operation theatres
Example
AIA: 55 – 60 m2
NHS: 55 m2
Australasian: 42 – 52 m2
Canadian: 48 – 55 – 60 m2
Germany: different standards

6. 6
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AUS SICHT DES KRANKENHAUSES
What is the minimum clear door
opening in patient rooms?
International projects, state of the art?

7. 7
1. Standards for clear opening in patient room doors
Example
AIA: 1.12 m clear opening
Recommendation for clear opening more than 1.22 m
NHS: 1.30 m structural opening
Recommendation for opening of minimum 1.50 m
Germany: 1.10 m clear opening
In the average around 1.25 m

8. 8
OUTPATIENTS
INPATIENTS
Standard for Safety – Standards for All?

9. The Architect’s Perspective –
Clinical Path Ways and Workflow
Economy
Meets
Humanity
Standard for Workflow and Schedule of Accommodation?

10. 10

11. 11
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11
STANDARDS FOR………
Hotel
Nurse-school
Home for dementia
Home for the Elderly
REHAB
Imaging
Outpatient Department
Public Health Office
Private Hospital
Special. Clinics
Daycare Operation
Centre
Hospice Health-Park
Phyiotherapy
Lifestyle and Spa
Core-Hospital

12. 12
STANDARDS NHS, DIN, NHS and Australasian HFG

13. 13
Source: Dr. Ing. Monika Schill-Fendl, Planungsmethodik
AIA, NHS and German regulations
Agenda

14. 14
1. National insurance regulations, protection of staff
Germany – different requirements

15. 15
1. National insurance regulations, protection of staff
Germany – different requirements

16. Working Draft - Last Modified 4/3/2010 12:54:41 PM
Design
Concept
–
Staff
area

17. TRACKER
Working Draft - Last Modified 4/3/2010 12:54:41 PM
Design
Concept
–
staff
change

18. 18
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DIN 13080
DIN

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1. Syn-energy for the new hospital
German DIN

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Using the German DIN for schedules of accommodation

21. Actual location, United Arab Emirates

22. 6
Rehabilitation
Clinic
250 beds
Ideal distribution of ward area according to Business Planning:
• V VIP
• VIP
• Single
• Double
• Clinic Standard (double)
TOTAL
• All relevant medical specialties and diagnostic equipment
• separated workflow and VIP suites for Medical Check Ups
• Room categories according to Rehab Clinic
 use guest rooms as overflow for rehab patients
Outpatient Center
with Diagnostic
Boarding House/
Accommodation
Mix of Rehabilitation, Outpatient Center and Hotel
# Rooms # Beds
10
20
60
60
20
170
10
20
60
120
40
250

23. Main sections

24. 24
Healing Architecture

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Using the German DIN for schedules of accommodation

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NHS example OT

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NHS layout examples – here OT

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NHS layout examples – here OT

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AIA structure
AIA

30. 30
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AIA example

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AIA for Cath lab
Agenda

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2. Case Study 1: planned in accordance with AIA, not acceptable for NHS?
Agenda

35. 35
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Comparison AIA and NHS
Agenda
Main difference between US and UK NHS design principles for Cath Lab:
In the US (AIA), a dirty utility room is not required to be adjacent to the cath
lab room
In the US (AIA), rooms for preparation and anaesthesia could be shared and
do not have to be adjacent to the cath lab procedure room
In the UK (NHS), the cath lab shall have the following adjacent rooms:
Anaesthesia, preparation, store room, scrub and gowning and control room.

36. 36
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Following AIA, but not NHS

37. 37
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1. Syn-energy for the new hospital
Agenda

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1. Syn-energy for the new hospital
Agenda

39. 39
Agenda
Main differences between US and UK NHS design principles for OT:
In the UK (NHS), the direct access of the scrub / gowning room, Anaesthetic, Dirty
Utility and Preparation room is mandatory
In the UK (NHS), the room for preparation is only not needed if the preparation could
be done under the ultra-clean canopy in the operation theatre itself
In the US (AIA), the ANAE area is the so called “induction room”, and this room
could be shared between the OT and also be located not directly adjacent to the OT
In the US (AIA), shared scrub zones can be located outside of the OT, in a more or
less open zone (ventilation system to be designed in a way that a “air curtain” is more
and less prohibiting water from the scrub to come contaminate other areas)
In the UK (NHS), separated single room recovery spaces are requested. In the US, a
curtain between recovery spaces can be accepted
In the US (AIA), the transfer from the patient bed to the OT stretcher could be done
in the OT. We do not see any clear requirements / procedure in the NHS guidelines.
Here, we can only find the following: “increasing number of patients are transferred onto
their beds rather than a trolley. A bed is significantly larger than a trolley.”
In the UK (NHS), there are many requirements for the admission lounge, waiting
room, administration office as integral to communication base etc. which are more
and less referring to very specific workflows and procedures. Here, many of these basic
requirements (also for ambulant / outpatient) are not fulfilled and must normally being
discussed with the user.

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NHS layout examples – here OT

41. 41
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AIA extract
AIA for OT

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3. Case Study 2: Third Party Review and standards – please re-design?
Agenda

43. Working Draft - Last Modified 4/3/2010 12:54:41 PM
AIA
Guidelines
-
Comparison

44. Working Draft - Last Modified 4/3/2010 12:54:41 PM
AIA
Guidelines
-
Comparison

45. 45
1. Is our design wrong?
Third party review according to AIA

46. 46
1. Is our design wrong?
Third party review according to AIA

47. 47
1. Is our design wrong?
Third party review according to AIA

48. 48
1. Is our design wrong?
Third party review according to AIA

50. 50
1. Is our design wrong? It is an ICU renovation project……..
Third party review according to AIA

51. 51
1. Is our design wrong?
Third party review according to AIA

52. 52
1. Is our design wrong?
Third party review according to AIA

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4. Accreditation and Planning Standards – JCI instead of AIA/NHS/DIN
Agenda

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Hospital Standard and JCI, example

56. 56
Hospital Standard and JCI, example

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5. HAAD Abu Dhabi standards, based on Australia hospital standards
Agenda

58. 58
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi

59. 59
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi

60. 60
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi

61. 61
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi

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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi

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6. Outlook and recommendation – what to follow?
Agenda

64. C
u
s
to
m
e
rs
re
q
u
ir
e
m
e
n
ts
Workplace design
There is no standard workplace design!
Standards are good, but……………..

66. Designing for Operational Change

68. 68
7. Questions and Answers
Agenda

69. 69
Hospital Planning and Building Standards – AIA, NHS, DIN
INTERNATIONAL HEALTHCARE BUILDING STANDARDS &
CODES – LATEST ON HARMONIZATION OF CODES AND
ACCREDITATION
HENNING LENSCH, RRP International Hospital Planners Pte Ltd
Munich-Germany-Singapore
September 2013
Toronto UIA 2013