Hospital Engineering Services

Dr (Prof) R N Basu
 Introduction
• The engineering services of a healthcare facility support the
delivery of patient care and help to maintain a healing and safe
environment.
• Engineering services are integral part of hospital infrastructure
• Engineering services account for approximately 35-40% of the
capital costs in the construction of health care facilities
• The requirement for the healthcare design is that it facilitates
high quality patient care for the most cost effective capital and
recurrent cost
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 Introduction (Contd.)
• Engineering services have large contribution towards
shaping the environment of care
• The goal of Environment of Care is to provide a safe,
functional and supportive environment for patients,
staff and visitors
• The environment of care is composed of the building,
the equipment and the people
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 Components of Engineering Services
• Engineering services of a hospital include:
– The civil assets - Includes:
• Building, Roads, Storm Water Drainage, Waste water drainage,
Sewage Treatment Plant
– Electricity supply
– Water supply including plumbing and fixture
– Steam supply
– Acoustics and Lighting
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Components of Engineering Services
– Piped medical gas and vacuum system (PMGV)
– Air conditioning and refrigeration
– Lifts, pneumatic tube system and dumbwaiters
– Public health services
• Solid Waste Disposal System
– Communication system, paging, CCTV
– Building management system
– Workshop facilities for repair and maintenance

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 Civil Assets
• Hospital building is a complex structure
– The layout, space, circulation should conform to national and
international guidelines
– The form of the building should follow function
– The design and construction of the building should be environmentally
sustainable
– It should provide a safe, patient friendly and healing environment
– The design should be evidenced based

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 Communication
• Communication services required are:
– Assistance Call system
– Building services monitoring
– Data Communication
– Door call
– Radio paging
– Public Address
– Duress Alarm System
– Voice Communication System

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 Maintenance Services
• Objective of building maintenance is to provide an optimum
medical and operational environment at all times
• The maintenance service may be in-house or outsourced
with an on-call repair service
• Following areas require 24 hour per day, 7 day per week on-
call maintenance service:
– Medical gases and suction system
– Lifts

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 Maintenance Services
– Fire systems
– Bio-electronic equipment
– Any life-support systems
– Boiler plant
– Telecommunication system including:
• Paging
• Emergency warning and Intercommunication system
• Nurse call

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 Electrical Services
• Electricity is vital to hospital operation and patient
safety
• Electrical services shall include:
– Provision of normal, vital (30 sec.), instantaneous (1 sec.),
and uninterruptible (no break) electricity supplies
– Switchgear and circuit protection to safely operate and
control the supplies
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 Electrical Services
– Distribution arrangements to supply electricity to each end
use
– Equipment to transform and condition voltage from supply
voltage to end use voltage and within voltage and
frequency tolerances
– Equipment to use the electricity for lighting, heating and
motive power

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 Electrical Services
• High Voltage Installation
– Where there are high voltage transformers and switch gear on site it
shall:
• Either be housed in buildings or structures remote from patient areas or be
located in a fire isolated part of the main building
• Only be accessible to authorised persons
• Provided with instantaneous lighting served from the vital electricity supply
• Provided with instantaneous power to control switching served from the
vital electricity supply

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 Electrical Services

• Earthing
– There shall be an earthing diagram mounted in the main
switch room
– This shall identify the earthing arrangement of the system
and
– Earth resistance parameters to be achieved

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 Electrical Services
• Cabling
– Cabling should have a 25% spare capacity above the
calculated maximum demand
– Cabling shall be located so as not interfere with medical
equipment sensitive to magnetic fields
– Cabling carrying heavy loads should not be located adjacent to
ICU, OT, and similar areas where electro-cardiograph-
monitoring equipment is to be operated
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 Electrical Services

• Emergency / Vital (30 second) Electricity Supply

– Generators should have fuel supply arrangements that will
keep them in operation for the longest credible normal
supply outage
– Be installed in an environment where they can be serviced
and maintained in the most unfavourable conditions

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 Electrical Services
• Instantaneous and Uninterruptible Electricity Supplies
– The following lighting to be connected:
• Fixed Surgical Luminairs
• Procedure Room Examination Light
• Birth Room Examination Lights
• Emergency Evacuation and Exit Lights
• PABX, Paging, Alarm and Call System Supplies

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 Engineering Services, Fire
• Fire services shall be provided to comply with
requirements of National Building Code, 2005
• These shall include (but not limited to):
– Provision of materials and methods of construction to
comply with codes and regulations
– Compartmentation of the buildings into fire and smoke
compartments
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 Engineering Services, Fire
– Provision of complying fire egress arrangements
– Provision of fire and smoke alarms
– Storage arrangements for fire fighting water
– Fire fighting water pressure boosting arrangements
– Provision of smoke clearing ventilation
– Provision of escape route air pressurisation
– Provision of hose reel and hydrant fire extinguishing equipment
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 Engineering Services, Fire
– Provision of automatic fire extinguishing systems
– Provision of portable fire extinguishers
– Provision of equipment to aid transportation of disabled
persons
– Provision of escape diagrams

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 Engineering Services, Hydraulic
• Extent of Services
– Cold potable water service
– Hot potable water service
– Warm potable water service
– Water filtering and conditioning equipment
– Water storage tanks
– Gardens and ground irrigation
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 Engineering Services, Hydraulic
– Bore water supplies
– Sanitary drainage service
– Process waste water discharge conditioning facilities
– Sanitary fittings and fixtures
– Roof plumbing
– Storm Water Drainage
– Sub soil drainage
– Sewage treatment facilities

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 Engineering Services, Hydraulic

• Drinking Water Specification (Indian Standard)

– IS 10500: 2012
• Water requirement
– 450 Lit per bed per day

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 Engineering Services - Mechanical

• Mechanical services may include but not be limited to:

– Air cooling and heating services
– Building automation control system
– Energy Management System
– Ventilation services
– Plants and Machinery

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 Engineering Services - Mechanical

• Ventilation Service
– Good ventilation is fundamental to proper hospital function
– It shall provide breathing air free from contamination
harmful to building occupants
– Capture as close as practicable to source, any air
contaminated by persons or processes within the buildings
and remove it to discharge at a safe place
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Engineering Services - Mechanical
– Provide special air environments for:
• Isolation and infectious disease
• Protection of immuno-deficient patients
• Surgery
• Handling sterile instruments and goods
• Safe handling and storage of hazardous materials
• Body holding, viewing in mortuary areas
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Engineering Services - Mechanical
– Provide air pressure to control outside air infiltration and
provide an internal airflow gradient from clean to dirty areas
and processes
– Provide air flow or pressure, in the event of fire, to prevent
smoke entering escape routes

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 Engineering Services – Medical Gases

• Medical gas services may include but not limited to:

– Oxygen storage and distribution
– Nitrous oxide storage and distribution
– Compressed air storage and distribution
– Medical suction pumping storage and distribution

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 Which System to select?
• For smaller hospitals, where the demand is typically
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below 3000 m per annum, the most cost-effective
method of supplying medical oxygen is from a
compressed gas cylinder manifold.
• As the demand increases, it becomes less practicable
to use compressed gas cylinders and more cost
effective to use medical liquid oxygen
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 Which System to select?
• Liquid cylinders are ideal for an annual consumption of between
3000 m3 and 40,000 m3
– They can be connected together by a manifold to provide adequate
storage capacity and flow rate.
• For hospitals with larger demands, a bulk medical oxygen VIE
will generally be used
• There is a nominal overlap of annual consumption between
27,500 m3 and 40,000 m3,
– Here, either a bulk VIE or a liquid cylinder installation could be
considered
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 Services - security

• Extent of services
– Access control systems
– Asset tracking systems
– Video surveillance systems
– Door intercommunication system
– Security lighting

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 Lifts

• Any building of more than one storey shall have

adequate lifts to provide safe and reliable vertical
transport for persons and goods
• The number of lifts and their size, speed and load
carrying capacity shall be determined by a professional
analysis

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 Lifts

• Healthcare buildings are dependent on lifts

– They provide an efficient, fast, comfortable, safe and
reliable vertical transportation for movement of staff,
patients, visitors, medical equipment and ancillary services
items
– Required also for fire fighting and evacuation facilities
– Lifts are subject to strict statutory regulations
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 Lifts
• Location
– Should be based on medical function and service function such as
goods, fire fighting, etc
– Lifts should be located away from sensitive areas
– Wherever possible lifts should be provided, at least in pairs, to
provide service in the event of breakdown or unavailability for
maintenance or inspection
• Types
– Passenger, goods/passenger and goods only
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 Lifts
– They fall into one of the following categories
• General passenger lifts,
• trolley /stretcher lifts,
• bed lifts,
• goods lift, and
• service lifts

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