The core of hospital building cost control: the pursuit of "minimum use standards" and "maximum affordability" of moderate values. It is reflected in the quality cost area chart, that is, the appropriate area for the pursuit of quality cost. As can be seen in Figure 1, there is an optimal quality point, which is the combination of the lowest cost and the higher quality, which is the appropriate value that we are looking for. Through the needs of different scales, regions and populations, the cost of quality control is reasonably adjusted, so that the architectural design of general hospitals tends to this suitable value.
The construction cost of a hospital refers to the factors of production consumed in the construction process of the hospital, which mainly depends on both the medical unit and the public space. Specifically, relevant strategies are proposed from the aspects of spatial scale, formal layout and functional accommodation.
1.Modular development of medical units.
The general hospital consists of four basic units: nursing, outpatient, imaging and surgery, covering the core functions of outpatient, medical technology and inpatient, and then extends to the entire medical area.
1.1. The choice of medical standards.
The minimum space of the basic unit of the hospital depends on the basic scale of medical behavior, which is determined by the relevant personnel scale and the size of the medical equipment.
1.Excerpt of 2 basic modules.
The base module is centered around the infrastructure within the unitto explore the patterns of movement of patients and caregivers, and to derive the common range of activities of facilities and users. Taking the ward and clinic units as examples, the spatial scale is controlled by the behavior module, and the appropriate scale of the basic unit is obtained.
The ward unit is divided into three modules: recuperation, activity, and toileting. The recuperation module determines the basic size according to the length of the bed, and considers the spacing between the beds to determine the size of the recuperation module 22*2.3m, clear height 28m。The movable module takes into account the size of the pusher plus the spacing between the two sides to determine the width of the aisle 11m, clear height 24m。The toilet module considers the shower stool, handrail and infusion hook, and determines the minimum size of the bath module to be 10*1.2m, toilet module is 11*1.0cm, the clear height should be 22m。
The outpatient unit is divided into two modules: the examination area and the examination area. The consultation table of the consultation module should be set up in a T shape, and the consultation table plus the medical assistant and the patient's seat should be controlled at 20*2.0m, clear height 26m。The periphery of the examination module is enclosed by a curtain, and a patient hanger is set inside to meet the needs of patients. Periphery 04-0.5m of buffer space. The overall range is controlled at 125*2.25m。
1.A combination of 3 unit types.
The hospital building itself is a highly adaptable organism, and if all functions are built according to minimum standards, it will face the problem of renovation and renewal. In order to achieve long-term development, it is necessary to leave room for development in terms of scale, function, and unit type. Taking the ward and outpatient units as examples, combined with the modular column network layout, the practice of moderation design is briefly described.
Wards are divided into single, double and multi-person beds. As the number of people in the room increases, the economy rises and the comfort decreases. For example, the average size of the bed in a single room is 215m2, enjoy a separate bath and toilet; The average size of the bed in the quadruple room is only 93m2, shared toilet facilities. As shown in Figure 4, the minimum size of the two-person standard room is 36*6.9m。The more economical inpatient unit size is 72*7.2m, that is, two standard rooms can be accommodated in one column network. Quite a few hospitals use 78*7.The 8m column grid is a scale with high comfort. If the size of the column is greater than 80*8.0m, it is more luxurious. Therefore, the moderate value of the column scale should be 72m—8.0m.
Clinics are divided into single, dual, and multi-doctor. Each desk in a double clinic is 84m2, 10 for a single doctor5m2, the former is better than the latter in terms of economy. As shown in Figure 5, the minimum space of the consultation room is 27*4.2m。The size of the column grid of the outpatient and emergency department is slightly larger than that of the inpatient department, and the column grid that can accommodate the three smallest units of the consultation room is 81*8.1m is a relatively economical scale. For the flexibility of space, it can be appropriately expanded. Take 8For example, in the section with a depth of two column grids, the layout of doctor-patient separation is adopted, with the patient waiting area in the center, consultation rooms on both sides, and an internal corridor on the outside. In each surface width column network, 3 single diagnoses, or 2 double diagnoses, or 1 multiple diagnosis and 1 single diagnosis can be set up, and several functional modules can be flexibly combined.
The basic unit is an important means of controlling the medical space, in addition to considering the medical process or the improper proportion and configuration of the room, it is more important how to accommodate the behavior of medical care, patients and equipmentIn terms of the "applicability" and "ease of use" of the unit space, the cost reduction and the expansion of space are considered.
1.4 Moderation of the medical unit.
The appropriateness of medical unit cost control should be appropriately differentiated according to the level of the hospital. First-class general hospitals meet the "minimum use standards", and the medical scale is taken as the lower limit, which mainly meets the medical function. It is specially set up for common conditions, so there is no need to add multi-functions and expand medical space. The secondary general hospital is in the middle, and the comfort and economy are emphasized. **The improvement of the standard of general hospitals should consider the "maximum bearing limit", and the minimum area is determined according to the basic module, and a certain amount of space comfort is added. For example, adding a companion space to the patient room, expanding the examination area in the examination room, etc
2.Flexible expansion and expansion of public spaces.
The following takes a representative outpatient comprehensive hall space as an example to briefly describe the practice of cost control from the perspective of form pattern, basic scale and functional expansion.
2.1. Selection of form layout.
For cost control of the outpatient comprehensive hall, it is necessary to choose the appropriate form layout according to the scale and land use of the hospital. The absolute division of the hall increases the unnecessary traffic area and affects the efficiency of medical care, and is rarely used now. The main form of the hall is the current mainstream, and the basic forms include the hall hall, the hall and the street hall
Combined hall type: the functions of the outpatient clinic are all placed in the complete hall, and the **-laboratory-charging-taking medicine is reasonably arranged according to the medical treatment process, which is mostly seen in small and medium-sized hospitals, and is a connected space on the 2-3 floors; Combined with the "shared space" commonly used in hotels, the large general hospital has evolved into an atrium-style comprehensive hall on the 3rd to 4th floors, with a more compact layout.
Connecting halls: 2-3 halls (outpatient clinics, ** medicines) are connected together, and most of them are "recessed space" as the medium, and public departments are inserted into the block in different directions. Compared with the hall type, the functions are assigned and combined, rather than compounded together, and have relative independence. This layout occupies a large area and is a form of setting up for large general hospitals, which is not suitable for small and medium-sized enterprises. It is worth noting that the connection surface should be wider, otherwise it is no different from the branch hall, and the complementary behavior of the space will be reduced.
Street hall type: It is the backbone of the hospital skeleton, with a height of more than 3 floors. Compared with the first two, the aspect ratio of the latter hall is often more than 1:5. Suitable for hospitals of all sizes: from the perspective of saving area, small and medium-sized hospitals integrate the "hall" into the "street" and become a part of the "street"; Large-scale hospitals liberate the "hall" from the front end, and arrange corresponding service spaces on both sides of the "street".
2.2. Definition of spatial scale
The scale of public space is comprehensively defined based on the number of people, spatial perception and functional needs. With the popularization of the outpatient "gold card", the function of the outpatient hall has a tendency to compress, and the area of the hall is reduced accordingly, and the lower limit of the range value can be taken.
The suitability of the sense of space is determined by the height of the building and the distance between the buildings. Set the height of the building to h and the distance of the observer from the building to d. When h d=1, the building height and distance are in a uniform existence, which is the optimal point of the spatial scale. With the decrease of H d, the building will have a sense of distancing, and when the ratio is 1 2, it can still produce a sense of cohesion. When the ratio is 1 3, there will be a feeling of emptiness; If the ratio is reduced again, it will create a sense of desert. As H d increases, proximity occurs when the ratio is 15. Strengthened cohesion; When the ratio is about 20, the cohesion reaches a very high degree; If the ratio increases, anxiety will occur
In the outpatient hall, the height of the atrium is set to h, and the length and width of the atrium are set to l and w, and the values obtained by h l and h w are discussed in combination with examples. As shown in Figure 7, the ratio of h w to h l of the atrium is 04-2.0, the degree of cohesion is enhanced by weak, and it is within the range of human spatial acceptance. Among them, the suitable ratio of 3-4 layers is 04-1.0, the suitable ratio of more than four layers is 10-2.0。In the range of the individual, the larger the ratio, the higher the utilization degree of the area, and the better the economy. Vice versa.
2.3. Accommodation of ancillary space.
Ancillary spaces in the common realm include commercial, service, and leisure. With the improvement of the humanization of patients and the improvement of hospital operation, there is a growth trend, and there is an excessive phenomenon, which needs to be adjusted accordingly according to the hospital's own situation.
Most of the commercial spaces are small supermarkets, flower shops, bookstores, barber shops, cafes, restaurants, etc., which are generally set up independently in combination with the outpatient hall and the hospital street to meet the actual needs of users。Service spaces such as water dispensers, TMs, newsstands, bulletin boards, etc., are small in size and scattered in lobbies and corridors that are easily identifiable. Leisure space belongs to a higher level of requirements, such as indoor green areas, various forms of waiting seats, air corridors, etc., often not limited to the form, or directly arranged in the hall, or combined with the outdoors to create a gray space.
2.4. Moderation of public space.
The focus of cost control in public space is different from that of medical space: medical space is limited by specific medical facilities and medical behaviors; The public space should be appropriately selected in terms of layout form, area scale and functional facilities. The "degree" of control of public space should be appropriately differentiated according to the level of the hospital.
For first-class general hospitals, the form of the consultation hall should adopt the 1-2F hall type, and the required functions should be arranged in it, and strive to be compact and simple. The waiting space can be set up once to wait for treatment, and the corresponding waiting area is left in front of the consultation area. The attached space is equipped with necessities such as a small supermarket and a flower shop.
For secondary general hospitals, the form of public space adopts the form of "hospital street", which integrates "street" and "hall" on a small scale to reduce the construction cost; On a large scale, the front end of the "street" is turned into a "hall" to meet the centralized functional rooms. For the main axis of the "Hospital Street", which is controversial in terms of construction cost, the width of the corridor can be appropriately reduced to avoid waste. The width of the corridor can be increased, facility seats can be added as a secondary waiting list, and ancillary functions such as rest areas and viewing areas can be set up
For ** general hospitals, there has been a significant increase in size and functionality. The form of the outpatient hall adopts the form of a joint hall, and the function is relatively independent. Considering the large area of the hall, according to the suitability of the sense of space, the form of height of more than three floors is adopted. The initial cost is high, and the comprehensive trade-off of the use effect, brand effect, etc., is still beneficial in the long run. Due to the large number of patients and attendants, bookstores, cafes and restaurants should be set up as ancillary functions to bring some additional income to the hospital.
Conclusion:
The concept of cost control is applied to the general hospital building, which is to make the architectural design of the general hospital tend to be the appropriate area for cost through the needs of different scales, regions and populations, through design improvement and process improvement, and to achieve cost control through design countermeasures and methods. The scale, functional configuration and spatial form of the building were selected as the elements of the study, and the adaptation range under different conditions was summarized. It is hoped that the research results of this paper can provide valuable reference for the theoretical system of general hospital architecture, the development of existing hospitals and new projects in the future.