Foreword

TCVN 4470:2012 replaces TCVN 4470:1996.

TCVN 4470:2012 was converted from TCXDVN 365:2007 in accordance with the provisions of Clause 1, Article 69 of the Law on Standards and Technical Regulations and Point b), Clause 1, Article 7 of the Government’s Decree No. 127/2007/ND-CP dated August 1, 2007 detailing the implementation of a number of articles of the Law on Standards and Technical Regulations.

TCVN 4470:2012 was compiled by the Institute of Architecture, Urban and Rural Planning, proposed by the Ministry of Construction, appraised by the Directorate for Standards, Metrology and Quality, and announced by the Ministry of Science and Technology.

1. Scope

This standard applies to the design of new construction, renovation and upgrading of general hospitals nationwide with a scale of over 500 beds.

NOTE: In case the general hospital has special requirements, it must be clearly stated in the project of construction investment and approved by competent authorities.

2. Referenced Documents

The following referenced documents are indispensable for the application of this standard. For dated references, only the edition cited applies. For undated references, the latest edition of the referenced document (including any amendments) applies.

TCVN 2622, Fire protection for buildings and structures – Design requirements

TCVN 4474, Internal drainage – Design standard

TCVN 4513, Internal water supply – Design standard

TCVN 5502:2003, Domestic water supply – Quality requirements

TCVN 5687:2010, Ventilation and air conditioning – Design standard

TCVN 6160, Fire fighting and prevention. High-rise buildings – Design requirements

TCVN 6561_, Ionizing radiation safety at medical X-ray facilities_

TCVN 6869, Radiation safety. Medical exposure. General provisions

TCVN 6772, Water quality. Domestic wastewater. Allowable pollution limits

TCVN 7382:2004, Water quality. Hospital wastewater – Discharge standards

TCVN 9385:2012(1), Lightning protection for buildings – Guidelines for design, inspection and maintenance of the system

TCXDVN 264:2002(2), Buildings and works – Basic principles of building construction to ensure accessibility for persons with disabilities

3. Terms and Definitions

For the purposes of this standard, the following terms and definitions apply:

3.1. General Hospital
A facility for medical examination, treatment and health care for patients, including several specialties and disciplines.

3.2. Department of General Medicine and Outpatient Treatment
A clinical unit responsible for receiving, examining, diagnosing, classifying, providing initial treatment for patients within its scope of responsibility, implementing outpatient treatment, and providing health care counseling.

3.3. Internal Medicine Department
A clinical unit that performs non-surgical methods to diagnose and treat diseases. The internal medicine department mainly treats patients with medication, sometimes accompanied by procedures.

3.4. Surgical Department
A clinical unit that performs medical examination and treatment mainly through procedures and surgeries.

3.5 Obstetrics and Gynecology Department
A clinical unit responsible for delivery, maternal health care, neonatal care, and gynecological examination and treatment.

3.6. Pediatric Department
A clinical unit that provides treatment, health care, and medical examination for children from newborn to 15 years old.

3.7. Infectious Disease Department
A clinical unit that treats patients with infectious diseases.

3.8. Emergency Department
A clinical unit that treats and provides intensive care to critically ill patients whose vital functions are threatened and require support.

3.9. Intensive Care and Toxicology Department
A clinical unit that continues intensive treatment and care for patients from the Emergency Department, detects and treats patients with acute poisoning, and identifies toxins through tests.

3.10. Traditional Medicine Department
A clinical unit that examines and treats diseases using traditional medicine methods.

3.11. Physical Therapy and Rehabilitation Department
A clinical unit that performs medical examination, treatment and rehabilitation for people with impairments, reduced functions and disabilities. Rehabilitation is a combination of medical measures and treatment methods to reduce impairment, functional limitation and disability.

3.12. Oncology Department
A clinical unit specializing in caring for and treating cancer patients with chemotherapy, radiotherapy and prevention.

3.13. Nuclear Medicine Department
A clinical unit that uses nuclear techniques to diagnose and treat cancers.

3.14. Surgery and Anesthesiology Department
A clinical unit consisting of a system of operating rooms for performing procedures, surgeries and anesthesia recovery.

3.15. Diagnostic Imaging Department
A para-clinical unit that performs medical imaging techniques to diagnose diseases and monitor treatment results, using X-ray, ultrasound, MRI equipment, etc.

3.16. Laboratory Department
A para-clinical unit that performs hematology, biochemistry, microbiology tests to assist disease diagnosis and treatment monitoring.

3.17. Pathology Department
An examination unit that investigates structural and functional disorders of tissues in diseases and the relationship of these changes to clinical signs and symptoms.
It is a unit that performs biopsy tests, cytology, autopsy and ultrastructure examination.

3.18. Dialysis Department
A unit that receives and treats patients with acute and chronic renal failure, multiple organ failure using peritoneal dialysis, hemodialysis, hemofiltration, hemoadsorption, blood exchange, and plasma exchange techniques.

3.19. Endoscopy Department
A unit that performs specialized techniques and procedures to diagnose and treat diseases using instruments and equipment inserted into the patient’s body (diagnostic and therapeutic endoscopy for upper and lower gastrointestinal diseases, liver biopsy, liver abscess drainage, peritoneal biopsy, pancreatic biopsy, etc.).

3.20. Functional Exploration Department
A para-clinical unit that performs techniques using instruments, tools and equipment to check the functions of organs in the body such as electrocardiogram, electroencephalogram, electromyogram, cerebral blood flow, etc.

3.21. Pharmacy Department
A unit that supplies and manages the quantity and quality of common drugs and specialized drugs, prepares some drugs used in the hospital to meet treatment requirements.

3.22. Nutrition Department
A unit that organizes and provides daily meals for all inpatients with standardized normal and therapeutic diets.

3.23. Infection Control Department
A para-clinical unit that performs hospital infection control to improve the quality of patient care by reducing the risk of hospital-acquired infections.

4. General Provisions

4.1. The hospital must be designed in accordance with the development planning of the medical examination and treatment network, appropriate to the scale and regulations on management and professional operation as per current regulations [1].

NOTE: The scale of the hospital is determined depending on the population in the management area and in accordance with the hospital network planning approved by the Ministry of Health.

4.2. The hospital shall be designed in accordance with the building grade as prescribed in the classification and grading of civil works [2].

4.3. The design and construction of the hospital must ensure accessibility for people with disabilities, ensure the safety of life and health for users and the community [3], [4].

5. Requirements for Construction Site and General Site Planning

5.1. Requirements for Construction Site

5.1.1. The location of the construction site must comply with the approved planning, have convenient transportation and take into account future development needs.

5.1.2. Ensure good ventilation, quietness, and avoid areas with polluted environments.

5.1.3. Be consistent with the functional zoning identified in the general site planning of the city.

5.1.4. The scale of the hospital and the average gross floor area per bed are specified in Table 1.

Table 1 – Minimum Scale and Indicators of Hospital Construction Land Area

5.2. Requirements for General Site Planning

5.2.1. The layout solution of the hospital must meet the following requirements:

• Rational, no overlapping between departments and within each department;
• Best sanitary and disease prevention conditions for the Inpatient Treatment Area and the General Medicine and Outpatient Treatment Area;
• Meet the hospital’s future development needs.

5.2.2. The spatial organization of buildings and each part of the blocks in the hospital must meet the following requirements:

• Have separate paths for transporting medicines, food, clean supplies and dirty – infected items, corpses, garbage, etc.;
• Between aseptic and septic procedures must be separately partitioned;
• Have reasonable isolation measures between the Infectious Disease Department and other departments, and between different parts within the Infectious Disease Department.

5.2.3. The internal traffic system in the hospital must meet the following requirements:

5.2.3.1. Traffic flows do not overlap.

5.2.3.2. Convenient for the activities of staff, visitors, patients, logistics services, waste transportation and corpses. There must be at least two entrance gates:

• The main gate for patients, staff and visitors. Arrange a separate route for 24/7 emergency;
• The secondary gate for supplying materials, transporting waste, technical support and funeral services.

NOTE: It is advisable to arrange a separate gate for emergency and a separate gate for the funeral area.

5.2.3.3. The system of corridors, ramps, bridge corridors must be designed with roof and ensure convenient connection between building blocks, ensure accessibility for people with disabilities, stretchers, wheelchairs.

5.2.3.4. Internal traffic roads must allow fire trucks to access all areas of the hospital.

5.2.4. The maximum building density and minimum greenery density must comply with construction planning regulations [5].

5.2.5. Allowable limit distances from the red line to:

a) The outer face of the front wall:

• Patient building, examination building and technical block: not less than 15 m;
• Administrative and service building: not less than 12 m.

b) The outer face of the gable wall:

• Patient building, examination building and technical block: Not less than 12 m;
• Administrative and service building: not less than 9 m.

5.2.6. The minimum sanitary and safety distance between buildings and separately arranged works for patient buildings is specified in Table 2.

Table 2 – Minimum sanitary and safety distance between buildings and works for patient buildings

6. Project content and design solutions

6.1. General requirements

6.1.1. Project content

– Department of General Examination and Outpatient Treatment;

– Inpatient Treatment Area;

– Professional Technical Area;

– Administrative Management Area;

– Logistics and General Services Area.

6.1.2. Requirements for clear dimensions

6.1.2.1. Room height

6.1.2.1.1. The minimum clear height of rooms in the hospital is stipulated to be 3.0 m and may be changed according to the requirements of each department in the hospital.

The clear height of bathrooms, toilets, and soiled storage rooms shall not be less than 2.4 m.

NOTE: In case of using air conditioning, it is allowed to reduce the height for energy efficiency. If using air cleaning equipment, the height must be sufficient for installation according to specific requirements.

6.1.2.1.2. The clear height of areas in the Surgery Department is stipulated as follows:

– Height of sterile zone, clean zone: not lower than 3.3 m;

– Height of auxiliary zone: not lower than 3.0 m.

6.1.2.2. Corridors

– Width of central corridor: not less than 2.4 m;

– Width of central corridor (with stretcher movement, combined with waiting area): not less than 3.0 m;

– Width of side corridor: Not less than 1.8 m;

– Width of side corridor (with stretcher movement, combined with waiting area): not less than 2.4 m;

– Height of corridor: not lower than 2.7 m;

NOTE: Handrails must be arranged on both sides of corridors in the hospital to assist people with disabilities and patients. The installation height of handrails is from 0.75 m to 0.8 m.

6.1.2.3. Doors

– Height of doors: not lower than 2.1 m;

– Width of single-leaf doors: not less than 0.9 m;

– Width of double-leaf doors: not less than 1.2 m;

– Width of main doors to operating rooms, delivery rooms, emergency rooms and intensive care units: not less than 1.6 m;

– Width of main doors to radiography rooms: not less than 1.4 m.

– Width of toilet doors: not less than 0.8 m.

NOTE: The dimensions of corridors and doors of departments are regulated separately according to specific usage requirements.

6.1.2.4. Staircases and ramps

The design of staircases and ramps must ensure regulations on life safety and health for users [4] and meet the following requirements:

– Width of each stair flight: not less than 2.1 m.

– Width of stair landings: not less than 2.4 m.

– Slope of ramps: not less than 1:10;

– Width of ramps: not less than 2.1 m.

– Width of ramp landings: not less than 3.0 m;

– At the main entrance/exit, there must be a ramp for people with disabilities with a width not less than 1.2 m.

6.1.2.5. Elevators

– Elevator dimensions (cabin) must be sufficient for a patient stretcher and 04 people, width x length: not less than 1.3 m x 2.1 m;

– Dimensions of staff elevators, width x length: not less than 1.1 m x 1.4 m;

– Width of elevator doors: not less than 0.9 m;

– Elevator speed for patients: not greater than 0.75 m/s.

6.2. Department of General Examination and Outpatient Treatment

6.2.1. The Department of General Examination and Outpatient Treatment is located near the main gate, conveniently connected to the Professional Technical Area, especially the Emergency Department, Intensive Care and Poisoning Control Department, Laboratory Departments, Department of Diagnostic Imaging, Department of Functional Exploration, and the Inpatient Treatment Area.

6.2.2. The Department of General Examination and Outpatient Treatment is arranged according to a one-way examination room chain based on the hospital’s ranking. The minimum structure and number of examination places are specified in Table 3.

6.2.3. There must be an infectious disease examination room with a separate entrance and exit.

6.2.4. The pediatric examination room should have a separate entrance and exit, conveniently connected to the emergency section.

6.2.5. Gynecological examination and treatment rooms must be designed separately from obstetric examination rooms. Gynecological and obstetric examination rooms must have separate sanitary areas.

Table 3 – Minimum number of examination places

6.2.6. In the Department of General Examination and Outpatient Treatment, common and separate waiting areas for each examination room are designed with the following standards:

– From 1.00 m² to 1.20 m² for one adult waiting place;

– From 1.50 m² to 1.80 m² for one child waiting place;

– The number of waiting places is calculated from 15% to 20% of the number of examinations per day.

NOTES:

1) Waiting areas can be arranged centrally or distributed according to departments but must not be smaller than the above norms. When calculating, it is necessary to multiply by a factor of 2.0 to 2.5 for patient’s relatives.

2) In the waiting area, seats for people with disabilities must be arranged in compliance with construction regulations to ensure accessibility for people with disabilities.

6.2.7. The areas of rooms in the Department of General Examination and Outpatient Treatment are specified in Table 4.

Table 4 – Areas of rooms in the Department of General Examination and Outpatient Treatment

6.3. Inpatient Treatment Area

6.3.1. General requirements

6.3.1.1. The Inpatient Treatment Area includes patient rooms, administrative duty rooms, head of department room, deputy head rooms, storage, sanitary – changing rooms, procedure rooms, examination rooms within the department, doctor’s offices, nurse and orderly rooms, dining and living rooms for patients.

6.3.1.2. The Inpatient Treatment Area consists of the following departments:

6.3.1.3. The Inpatient Treatment Area of the Hospital must be designed according to treatment units with a scale of 25 to 30 beds according to the requirements of each individual department. The minimum structure and ratio of inpatient beds of specialties are shown in Table 5.

NOTE: The inpatient treatment unit includes the following sections:

– Patient rooms and patient living rooms;

– Staff working and living rooms;

– Professional rooms of the unit.

Table 5 – Minimum structure and ratio of inpatient beds by specialty

6.3.1.4. The number of isolated patient beds is calculated from 20% to 30% of the total number of inpatient beds of the department.

6.3.1.5. The area of patient rooms in the Inpatient Treatment Area is specified in Table 6.

Table 6 – Area of patient rooms in the Inpatient Treatment Area

6.3.1.6. The sanitary area for patients in the inpatient treatment unit should be arranged adjacent to each patient room to ensure each patient room has a sanitary area including: 01 sink, 01 toilet/urinal and 01 bathing/washing place.

NOTE: There must be at least one sanitary area accessible to people with disabilities in compliance with the provisions of TCXDVN 264:2002.

6.3.1.7. The areas of rooms serving the living activities of patients are specified in Table 7.

Table 7 – Areas of rooms serving the living activities of patients in the Inpatient Treatment Area

6.3.1.8. The areas of rooms in the inpatient treatment unit are specified in Table 8.

Table 8 – Areas of rooms in the inpatient treatment unit

6.3.2. Internal Medicine Department

6.3.2.1. The Internal Medicine Department must be located in the central area of the hospital, convenient for emergency resuscitation of patients and performing clinical tests.

6.3.2.2. Departments belonging to the Internal Medicine specialty: General Internal Medicine, Cardiology, Gastroenterology, Musculoskeletal, Nephrology – Urology, Endocrinology, Allergy, Tuberculosis, Dermatology, Neurology, Psychiatry, Geriatrics. When designing the Internal Medicine Department, it is necessary to comply with the general regulations in this section and other specific requirements (if any).

6.3.2.3. The treatment rooms in the Neurology Department must be separated: General neurological disease, infectious neurological disease. Infectious neurological disease must be arranged in a separate area and the patient rooms are designed like the patient rooms of the Infectious Diseases Department.

6.3.2.4. The patient rooms of the Psychiatry Department are arranged separately and divided into small rooms for patients according to pathology, with living and recreational rooms for patients who have passed the acute stage.

6.3.2.5. The minimum area norms for the Head of Department room, Doctor’s rooms, nurse’s rooms, administrative department… are calculated like the area norms for professional rooms in the inpatient treatment unit. The minimum areas of treatment rooms in the Internal Medicine Department are taken according to the regulations in Table 8.

6.3.3. Tuberculosis Department

6.3.3.1. The Tuberculosis examination room is located in the General Examination system of the Examination Department or attached to the treatment area of the department to form a separate unit.

6.3.3.2. The treatment unit of the Tuberculosis Department is designed as a separate unit.

6.3.3.3. It is recommended to arrange a system of sterile testing rooms for AFB and an X-ray room for anteroposterior – lateral chest X-rays.

6.3.3.4. Patient rooms are arranged separately according to disease classification: Pulmonary tuberculosis, extrapulmonary tuberculosis and extrapulmonary tuberculosis; each room from 02 beds to 04 beds. At least 01 patient room with 01 to 02 separate beds should be arranged for severe patients, isolated patients and 01 treatment room for tuberculosis/HIV/AIDS patients. Area norms for patient rooms are taken according to the regulations in Table 6.

6.3.4. Geriatrics Department

6.3.4.1. There should be a testing room located in the inpatient treatment department to perform routine tests and preliminary diagnosis.

6.3.4.2. In the department, 01 X-ray room should be arranged, with an area of not less than 24 m²/room.

6.3.4.3. Patient rooms should be arranged in a cool area, surrounded by flower gardens, large shady trees, with a relatively large space for light exercise. In the patient room area, there should be a dining room.

6.3.4.4. Patient rooms should be divided into different room structures to suit.

– Small room, 1 bed: For severe patients, dying patients, recently deceased and not yet transferred;

– 2-bed room: For relatively severe patients who need close monitoring;

– 5-bed room: For patients who can move around on their own.

NOTES:

1) Each patient room should have a separate sanitary and bathing area.

2) In case there are no conditions to separate patient rooms, it is possible to arrange a common patient room for patients who need monitoring and patients who can move around on their own, but there must be partitions.

6.3.5. Surgery Department

6.3.5.1. The Surgery Department must be arranged in a series, convenient for surgery, patient care and transportation.

6.3.5.2. The area norms for the Head of Department room, Doctor’s rooms, nurse’s rooms, administrative department… are calculated like the area norms for professional rooms in the inpatient treatment unit specified in Table 8.

6.3.5.3. Departments belonging to the Surgery specialty; General Surgery, Neurosurgery, Thoracic Surgery, Gastrointestinal Surgery, Urology, Orthopedics, Burns. When designing the Surgery Department, it is necessary to comply with the general regulations in this section and other specific requirements (if any).

6.3.6. Obstetrics and Gynecology Department

6.3.6.1. The Obstetrics and Gynecology Department should be arranged on the ground floor.

6.3.6.2. The composition and areas of rooms in the delivery section of the Obstetrics and Gynecology Department are specified in Table 9.

Table 9 – Minimum areas of rooms in the delivery section of the Obstetrics and Gynecology Department

6.3.6.3. The postpartum area accounts for about 50% of the beds of the Obstetrics and Gynecology Department, divided into many separate rooms including: room for parturients after cesarean section, normal delivery and infectious delivery.

6.3.6.4. It is necessary to arrange 01 room with 04 beds for patients staying from 12 hours to 48 hours after performing planned obstetric procedures.

6.3.6.5. The minimum areas of rooms in the gynecological treatment unit are specified in Table 10.

6.3.6.6. The patient room area of gynecological patients accounts for about 30% of the beds of the Obstetrics and Gynecology Department, divided into many separate rooms including: room for patients after surgery and room for patients under treatment.

6.3.6.7. Arrange 01 simple testing room in the Department to perform routine blood, biochemistry, urine tests, fresh microscopy, etc. Area standards and design requirements for the Testing Room see 6.4.3.

Table 10 – Minimum area of rooms in gynecological treatment unit

6.3.7. Pediatrics Department

6.3.7.1. The area standards and number of beds in a room of the pediatric unit are specified as follows:

– For newborns and infants: from 3 m²/bed to 4 m²/bed, with a maximum of 08 beds/room;

– For older children: from 5 m²/bed to 6 m²/bed, with a maximum of 06 beds/room.

NOTE: In case it is necessary to arrange eating and resting spaces for mothers, it must be stated in the investment report and approved by the Ministry of Health or the competent authority.

6.3.7.2. The minimum areas of living service rooms in a pediatric unit with 25 to 30 beds are specified in Table 11.

Table 11 – Minimum areas of living service rooms in Pediatrics Department

6.3.7.3. The minimum areas of rooms for newborns are specified in Table 12.

Table 12 – Minimum areas of rooms for newborns

6.3.8. Ophthalmology Department

6.3.8.1. The components and areas of treatment rooms in the Ophthalmology Department are specified in Table 13.

Table 13 – Areas of treatment rooms in the Ophthalmology Department

6.3.8.2. The visual acuity testing space must have a length of not less than 5 m.

6.3.8.3. There must be separate wards for infectious diseases (staphylococcus, pseudomonas, fungal, etc.).

6.3.9. Ear, Nose and Throat (ENT) Department

6.3.9.1. The minimum areas of treatment rooms in the ENT Department are specified in Table 14.

Table 14 – Minimum areas of treatment rooms in the ENT Department

NOTE: In case a hearing test room is needed, the required area must be stated in the construction investment report and agreed by the Ministry of Health.

6.3.9.2. The ear examination room must be designed with soundproofing according to professional requirements.

6.3.10. Oral and Maxillofacial Surgery Department

6.3.10.1. The minimum areas of treatment rooms in the Oral and Maxillofacial Surgery Department are specified in Table 15.

Table 15 – Minimum areas of treatment rooms in the Oral and Maxillofacial Surgery Department

6.3.10.2. In the Oral and Maxillofacial Surgery Department, X-ray rooms for a minimum of 01 to 02 dental X-ray machines and 01 Panoramic X-ray machine must be arranged. The area standards and design requirements for X-ray rooms are specified in 6.4.2.

6.3.10.3. A dental lab for 2 to 4 technicians must be arranged.

6.3.11. Infectious Diseases Department

6.3.11.1. In the infectious diseases unit, rooms must be divided according to disease groups. Each room must not exceed 2 beds, with an area of 7 m² to 8 m² per bed (including mattress area).

6.3.11.2. The areas of living service rooms for patients in the Infectious Diseases Department are specified in Table 16.

6.3.11.3. The following treatment rooms must be arranged in the infectious disease treatment unit:

– Treatment preparation room: from 9 m² to 12 m²;

– Infectious disease emergency room: from 15 m² to 18 m².

NOTE: For units with less than 10 beds, the treatment preparation room can be combined with the department’s emergency room, but there must be an isolation room and a separate entrance.

Table 16 – Areas of living service rooms in the Infectious Diseases Department

6.3.12. Emergency Department

6.3.12.1. The Emergency Department includes the following sections:

– Technical section: reception and triage, emergency space, diagnostic area (rapid testing, mobile X-ray), interventional procedure space.

– Support section: equipment – medicine, washing and sterilization, storage (clean, soiled), administration, meeting, training, duty, staff, sanitation/bathing/changing, department head.

6.3.12.2. The initial emergency section must be located on the ground floor, near the main gate of the hospital and separate from the Outpatient Department, adjacent to the paramedical departments, with emergency vehicles, including: reception area and emergency holding area (about 20 emergency holding beds to handle on-site emergencies brought in from outside). Space for an emergency team on duty must be arranged.

6.3.12.3. Next to the reception area, there must be a waiting room with chairs for patients’ families. For area criteria, see 6.2.6. The patient triage room is arranged next to the direct reception area.

6.3.12.4. The Emergency Department of a 500-bed general hospital must have at least 10 to over 20 holding beds and should arrange 10 beds/unit.

6.3.12.5. The areas of rooms in the Emergency Department are specified in Table 17.

Table 17 – Minimum areas of rooms in the Emergency Department

6.3.13. Intensive Care Unit (ICU) – Poison Control

6.3.13.1. The ICU – Poison Control includes the following sections:

– Technical section: reception hall, intensive care and monitoring space, interventional procedure space, detoxification and gastric lavage room, room for dying patients, equipment – medicine, washing and sterilization, clean storage, soiled storage, etc.

– Support section: Waiting area for patients’ families, administration, meeting and training, staff duty, sanitation, bathing, changing, department head, etc.

6.3.13.2. The ICU – Poison Control must ensure environmental sanitation requirements. It must have a synchronous technical infrastructure system, convenient for equipment installation and transport, and close to the medical gas, electricity, and clean water areas.

6.3.13.3. The ICU – Poison Control must have a hall large enough in case of disaster emergency, especially a mass shower system in case of a chemical disaster, and at the same time, there must be a room for scientific research and professional training on emergency, intensive care, and poison control for lower levels.

6.3.13.4. The operational flow of the ICU – Poison Control must ensure one-way clean-dirty requirements, be convenient, and promptly respond to emergency and intensive care, divided into two areas:

– Clean area: (Area with clean environment requirements)

+ Intensive care space, medical monitoring;

+ Interventional procedure room.

– Support area:

+ Hall, patient reception and triage;

+ Waiting room for patients’ families;

+ Emergency holding space;

+ Equipment – medicine room;

+ Washing, sterilization, enema room;

+ Clean storage;

+ Soiled storage;

+ Auxiliary techniques (X-ray, ultrasound, rapid testing, etc.);

+ Administrative office (doctor’s room, orderly room, meeting and consultation room, training room, etc.);

+ Sanitary area (washing, bathing/changing).

6.3.13.5. When organizing spaces in the ICU – Poison Control, the monitoring rooms must be partitioned with glass to ensure the following requirements:

– 100% of hospital beds can be observed;

– Patients, especially children, can be monitored;

– Monitoring patients’ families and visitors, communicating through glass partitions and microphones with patients;

– Having a nurse call system;

– Severely ill patients must have medical staff observe and monitor 24 hours/day.

6.3.13.6. The ICU – Poison Control of a 500-bed general hospital must have at least 15 to over 25 holding beds and should arrange 10 beds/unit.

6.3.13.7. In the ICU – Poison Control, there must be a toxicology testing room with an area of 20 m² to 24 m².

6.3.13.8. The areas of rooms in the ICU – Poison Control are specified in Table 18.

Table 18 – Areas of rooms in the ICU – Poison Control

6.3.13.9. The lighting system in the Emergency Department and ICU – Poison Control must prioritize natural lighting for the support area, combined with artificial and natural lighting for the clean area. The minimum illuminance requirements are specified in 7.4.4.

6.3.14. Traditional Medicine Department

The minimum areas of treatment rooms in the Traditional Medicine Department are specified in Table 19.

Table 19 – Areas of treatment rooms in the Traditional Medicine Department

6.3.15. Physical Therapy – Rehabilitation Department

6.3.15.1. The minimum number of treatment spaces in the Physical Therapy – Rehabilitation Department is specified in Table 20.

Table 20 – Minimum number of treatment spaces in the Physical Therapy – Rehabilitation Department

6.3.15.2. The minimum areas of rooms in the Physical Therapy – Rehabilitation Department are specified in Table 21.

Table 21 – Minimum areas of rooms in the Physical Therapy – Rehabilitation Department

6.3.16. Oncology Department and Nuclear Medicine Department

6.3.16.1. For general hospitals of Grade I with a scale of over 500 beds, if conditions permit, they can organize into two separate departments with a scale of over 30 holding beds or only organize an Oncology Department including two units: Radiotherapy and Nuclear Medicine.

6.3.16.2. The Oncology Department and Nuclear Medicine Department should be arranged on the 1st floor (ground floor).

6.3.16.3. The Oncology Department includes:

– Technical area: examination room, physics room, lead mold and support preparation room, simulation room, radiotherapy room, control room, radiation therapy room, brachytherapy room.

– Support area: patient reception, patient waiting space, treatment planning room, preparation room, patient temporary rest room, patient monitoring room before discharge, inpatient treatment room, storage, etc.

6.3.16.4. The Nuclear Medicine Department includes:

– Technical area: examination room, vivo diagnostics room, radiation device room, other radiation measurement device room, radiopharmaceutical room with exhaust ventilation, nuclear physics and electronics room, radiopharmaceutical injection – ingestion room;

– Support area: patient reception, patient waiting space, preparation room, treatment room, radiopharmaceutical storage, lead protective box, etc.

6.3.16.5. Requirements when designing radiotherapy rooms:

– The radiotherapy room is usually arranged on the 1st floor (ground floor) or basement, directly connected to the changing rooms, sanitation, examination, consultation and work rooms.

– There is only one single entrance with a thick solid door with radiation shielding layers;

– The radiation patient room is arranged next to the equipment room but must have a special structure with radiation leak-proof wall layers;

– Shielding must be implemented on all sides, including ventilation openings, heating ducts, doors, observation windows, and have safety locks without allowing even the smallest leakage hole.

– It must be certified for radiation safety by an appraising agency after the installation is completed.

– When designing, it is necessary to base on: machine type, intensity of the radiation source, location requirements, shielding requirements for floors, walls, ceilings and load-bearing structures.

NOTE: When designing a radiotherapy room, it is necessary to refer to the requirements of the equipment manufacturer.

6.4. Technical Service Area

The Technical Service Area includes the following departments:

1) Surgery – Anesthesia and Resuscitation Department;

2) Diagnostic Imaging Department;

3) Microbiology Department; (Testing departments)

4) Biochemistry Department; (Testing departments)

5) Hematology Department; (Testing departments)

6) Blood Transfusion Department;

7) Dialysis Department;

8) Endoscopy Department;

9) Function Testing Department;

10) Pathology Department;

11) Pharmacy Department;

12) Nutrition Department;

13) Infection Control Department.

6.4.1. Surgery – Anesthesia and Resuscitation Department

6.4.1.1. The location of the Surgery – Anesthesia and Resuscitation Department in the hospital must meet the following requirements:

– Arranged in the central area of the hospital, near the Intensive Care area, conveniently connected to the Surgical Treatment area and the Testing and Diagnostic Imaging departments;

– Placed at the end of the road, with no passing traffic and easy to control;

– Convenient for equipment installation and operation;

– Close to the supply of sterile equipment and technical systems, electricity, water, air conditioning, medical gases;

– Ensuring environmental sanitation conditions.

6.4.1.2. The Surgery – Anesthesia and Resuscitation Department is arranged centrally, organized according to the scale of holding beds (from 55 beds/operating room to 65 beds/operating room) divided by specialty and in accordance with the requirements for installation and operation of necessary equipment.

6.4.1.3. The operational flow of the Surgery – Anesthesia and Resuscitation Department must ensure one-way clean-dirty requirements, separate and divided into three levels of cleanliness.

– Sterile area:

+ Operating rooms;

+ Sterile corridor;

+ Consumables supply storage.

– Clean area: is the transitional part between the sterile area and the support area, including:

+ Pre-anesthesia;

+ Clean corridor;

+ Inter-surgery rest room;

+ Surgery record room;

+ Disinfection room (washing and cleaning of instruments and equipment);

+ Technical support (specialized equipment).

The support area includes the following sections:

+ Patient reception;

+ Recovery;

+ Administration, meeting and training;

+ Staff changing, sanitation area (bathing, washing, changing clothes, etc.);

+ Department head’s room;

+ Doctor’s room;

+ Nurse and orderly room;

+ Reception hall;

+ Waiting area for patients’ families.

NOTE: The design of clean rooms and clean areas needs to comply with current standards and regulations for the medical field.

6.4.1.4. The minimum areas of rooms in the Surgery – Anesthesia and Resuscitation Department are specified in Table 22.

Table 22 – Minimum areas of rooms in the Surgery – Anesthesia and Resuscitation Department

6.4.1.5. The Surgery – Anesthesia and Resuscitation Department must ensure lighting conditions according to the requirements for each area, prioritizing artificial lighting for the sterile area. The minimum illuminance requirements are specified in 7.4.4.

6.4.1.6. The operating area must have a connecting route to the Infection Control Department. Surgical specimens must be classified and treated according to the regulations on medical waste management.

6.4.2. Diagnostic Imaging Department

6.4.2.1. The Diagnostic Imaging Department is located in the central area of the hospital, must have a convenient connection with the General Outpatient Department and outpatient treatment, Inpatient Treatment area and common technical systems but must be separate from crowded areas.

6.4.2.2. Do not organize traffic routes passing through the Diagnostic Imaging Department to other areas.

6.4.2.3. The Diagnostic Imaging Department should be located on the ground floor, with the floor level above flood elevation (except for the ultrasound diagnostics area) for convenient installation, operation of equipment, patient movement and ionizing radiation safety control.

6.4.2.4. The Diagnostic Imaging Department must ensure absolute safety and radiation control according to TCVN 6561 and TCVN 6869.

6.4.2.5. The Diagnostic Imaging Department is divided into the following areas:

– Technical service area:

+ Preparation room (changing clothes and preparing patients);

+ Procedure room (enema, washing, anesthesia);

+ Diagnostic machine room;

+ Control room;

+ Film processing and classification room;

+ Film reading and image processing room.

– Administration, support and training area:

+ Reception hall combined with waiting area;

+ Registration, number taking and result return;

+ Administration office, meeting/training room;

+ Department head’s room;

+ Staff duty room;

+ Patient rest room;

+ Equipment and instrument storage;

+ Film and chemical storage;

+ Male/female staff changing and sanitation room;

+ Male/female patient sanitation area.

6.4.2.6. The solution for organizing spaces in the Diagnostic Imaging Department needs to ensure the following requirements:

– Sufficient area for machine installation, machine operation spaces and spaces for patient and staff activities;

– Separating patient and staff areas, one-way operational flow, non-overlapping, convenient for radiation safety control.

6.4.2.7. The minimum number of X-ray and fluoroscopy machines must ensure the current regulations and standards of the health sector.

6.4.2.8. The minimum areas of rooms in the Technical Area of the Diagnostic Imaging Department are specified in Table 23.

Table 23 – Minimum areas of rooms in the Technical Area of the Diagnostic Imaging Department

6.4.2.9. The X-ray and CT-scanner equipment rooms must meet technical requirements and ensure ionizing radiation safety, not allowing light to leak into the film processing room. The magnetic resonance imaging (MRI) system room must ensure electromagnetic wave shielding (or electromagnetic wave interference protection) and the electromagnetic field of the magnet in the machine room.

6.4.2.10. The item transfer box attached to the film processing room connects with the functional sections.

6.4.2.11. The observation window must meet the following requirements:

– Lead glass window ensuring radiation shielding ability;

– Lead glass observation window attached to the wall of the X-ray and CT-Scanner imaging room connecting with the control room, arranged 0.9 m or 1.2 m from the floor depending on the machine configuration;

– The minimum dimensions (width x height) of the glass window are:

+ for X-ray diagnostics room: 0.6 m x 0.4 m;

+ for CT-Scanner room: 1.2 m x 0.8 m.

6.4.2.12. The reception hall area must meet the following requirements:

– Arranging seats and communication devices (screens, speakers, boards). The number of seats is calculated as 8% to 12% of the number of patient visits to the department per day. For area criteria, see 6.2.6.

– Organizing a sanitation area combined with changing room for patients (separate for male/female);

– Registration, number taking and result receipt/return area: conveniently linked with administrative offices and film classification room.

6.4.2.13. The minimum areas of the administration and support area of the Diagnostic Imaging Department are specified in Table 24.

Table 24 – Minimum areas of the administration and support area of the Diagnostic Imaging Department

6.4.2.14. The technical service area in the Diagnostic Imaging Department must use artificial lighting and ventilation solutions. The minimum illuminance requirements are specified in 7.4.4.

6.4.3. Testing Departments

6.4.3.1. The Testing Departments in the Technical Service Block include:

– Microbiology Department;

– Biochemistry Department;

– Hematology Department.

6.4.3.2. The operational flow of the Testing Departments must ensure one-way clean-dirty requirements, separate to prevent cross-contamination. The facility is divided into cleanliness levels for each area.

6.4.3.3. The Technical Service Area is the main working space of the Testing Departments and the transitional space between the sterile area and the support area, including:

– Machine room;

– Medium preparation, sample and chemical preparation;

– Functional rooms according to the specialization of each department;

– Specimen storage, instrument storage;

– Washing, sterilization.

6.4.3.4. The support area for staff activities, including the following sections:

– Reception hall, result receipt/return;

– Support rooms according to the requirements of each department (patient rest, sample collection);

– Administration, meeting/training (doctor’s room, laboratory technician room, etc.);

– Department head;

– Storage (chemicals, supplies and medical equipment – instruments);

– Sanitation area (bathing, washing, changing, etc.).

6.4.3.5. The testing room must ensure safety for technicians and staff working in the department and the surrounding environment according to the highest anti-infection requirements in the hospital.

6.4.3.6. The minimum areas of rooms in the Testing Departments are specified in Table 25.

Table 25 – Minimum areas of rooms in the Testing Departments

6.4.3.7. The support area uses a combination of natural and artificial lighting solutions. The testing lab uses artificial lighting. The minimum illuminance requirements are specified in 7.4.4.

6.4.4. Blood Transfusion Department

6.4.4.1. The areas of technical service rooms in the Blood Transfusion Department are calculated similarly to the Hematology Department.

6.4.4.2. The treatment area for blood diseases can be separated or located within the General Internal Medicine Department.

6.4.4.3. The blood bank (if any) must be conveniently arranged with the Surgery Department, Emergency Department, Intensive Care and Poison Control Department, hematology lab.

NOTE: The establishment of a blood bank depends on the treatment level and scale of each specific hospital.

6.4.4.4. The minimum areas of rooms in the Blood Bank are specified in Table 26.

Table 26 – Minimum areas of rooms in the Blood Bank

6.4.4.5. The blood collection and storage areas must be separate, need to be separated from areas with vibration-generating or vibration-transmitting equipment and must be absolutely sterile.

6.4.4.5. Hospitals with a scale of over 500 beds, depending on specific cases, can organize into two separate departments: Hematology Department and Blood Transfusion Department. If only a Hematology-Blood Transfusion Department is organized, it is necessary to comply with the general regulations in 6.4.3 and 6.4.4 of this standard.

6.4.5. Pathology Department

6.4.5.1. The Pathology Department is divided into two areas:

– Technical service area (Pathology Lab): located in the lab area of the hospital. Requirements for space organization and infrastructure techniques are similar to a Testing Lab.

– Support area (Autopsy House): responsible for pathological dissection, storing corpses, storing specimens, models and carrying out funeral procedures. This section is arranged independently, at the end of the wind direction, with a separate gate for funeral services.

6.4.5.2. The Autopsy House must meet the following requirements:

– Having a direct door from the corpse storage room to the autopsy room and to the funeral room;

– The corpse storage and autopsy rooms must be well-ventilated, have mesh barriers and equipment to prevent flies, rats and insects. The corpse storage area must have refrigerators or cold rooms for preservation;

– The position of window installation must be at least 1.6 m higher than the outside sidewalk. The floor of the corpse storage room must be 0.2 m lower than the floor of the surrounding rooms and corridor;

– Wastewater from the corpse storage room must be treated through the hospital’s local wastewater treatment system before being discharged into the common drainage system.

6.4.5.3. The minimum areas of rooms in the Pathology Department are specified in Table 27.

Table 27 – Minimum areas of rooms in the Pathology Department

6.4.6. Dialysis Department

6.4.6.1. The layout organization of the Dialysis Department must be convenient, ensure the functional flow, divided into two main areas:

– Technical area including: dialysis equipment room, examination room, preparation room;

– Support area including: patient reception area, patient waiting space, patient temporary rest room, equipment washing and sterilization room, water – dialysate treatment equipment room, dialysis specialty biochemistry room, dialysis equipment repair and maintenance room, dialyzer reuse processing room, equipment storage, spare parts storage, consumables storage, etc.

6.4.6.2. It must ensure absolute sterility, preventing cross-infection between dialysis patients and dialysis staff.

6.4.6.3. A dialysis unit is arranged with 8 to 12 artificial kidney machines. The area of the dialysis room is calculated according to the standard of 10 m²/artificial kidney machine.

6.4.6.4. The repair and maintenance center for dialysis equipment and water treatment systems must ensure continuous operation 24 hours/day.

6.4.7. Endoscopy Department

6.4.7.1. The Endoscopy Department is divided into two areas:

– Technical area including: endoscopy and procedure rooms;

– Support area including: preparation rooms, washing and sterilization rooms, storage and training spaces.

6.4.7.2. The space of the Endoscopy Department must be arranged in a continuous and reasonable manner, ensuring professional work, sufficient area and infrastructure techniques.

6.4.7.3. Endoscopy rooms should be arranged near the recovery room or treatment rooms.

6.4.7.4. The minimum areas of service rooms in the Endoscopy Department are specified in Table 28.

Table 28 – Minimum areas of rooms in the Endoscopy Department

6.4.7.5. Ensure requirements for cleanliness and sterility levels.

6.4.7.6. Requirements for finishing and infrastructure techniques (electricity, water supply, etc.) must be equivalent to the Surgery Department.

6.4.8. Function Testing Department

6.4.8.1. The Function Testing Department is arranged in a convenient location for patients, with a cool and airy space.

6.4.8.2. The Function Testing Department is divided into two areas:

– Waiting area: organized like an examination room;

– Technical area: organizing function testing spaces, arranged adjacent to the equipment storage.

6.4.8.3. The minimum areas of rooms in the Function Testing Department are specified in Table 29.

Table 29 – Minimum areas of rooms in the Function Testing Department

6.4.9. Pharmacy Department

The minimum areas of rooms in the Pharmacy Department are specified in Table 30.

Table 30 – Minimum areas of rooms in the Pharmacy Department

6.4.10. Nutrition Department

6.4.10.1. The location of the hospital kitchen in the Nutrition Department must meet the following requirements:

– Convenient for transporting food to the patient rooms via the shortest route;

– Convenient for transporting food in and waste out.

6.4.10.2. The minimum areas of rooms in the Nutrition Department are specified in Table 31.

Table 31 – Minimum areas of rooms in the Nutrition Department

6.4.10.3. The area of the dining and refreshment area is calculated with the following area criteria:

– Under 100 seats: from 1.3 m²/seat to 1.4 m²/seat;

– From 100 to under 200 seats: from 1.1 m²/seat to 1.2 m²/seat;

– From 200 to under 300 seats: from 1.0 m²/seat to 1.1 m²/seat.

6.4.11. Infection Control Department

6.4.11.1. The Infection Control Department includes: Equipment and Medical Instrument Sterilization Center and Laundry Section.

6.4.11.2. The Equipment and Medical Instrument Sterilization Center includes basic equipment such as dryers, sterilizers, disinfectors, ultrasonic washers. The equipment installation area must be suitable with the manufacturer’s requirements and the receiving area and ensure a one-way clean-dirty flow.

6.4.11.3. At the Equipment and Medical Instrument Sterilization Center, it is necessary to design a water supply and drainage system according to requirements and collect wastewater to the hospital’s general treatment section.

6.4.11.4. The Laundry Section in the Infection Control Department is designed according to the areas specified in Table 32.

Table 32 – Design areas of the Laundry Section

6.4.11.5. The location of the hospital’s wastewater, waste, and specimen collection and treatment area must be placed at the end of the wind direction, far from the treatment area and not cause pollution to the surrounding area. The waste removal route out of the building must be separate from the main entrance.

6.4.11.6. Waste from the hospital must be managed according to regulations on medical waste management [6].

NOTE: Body parts from biopsy and research need to be classified and destroyed separately under appropriate technical conditions.

6.5. Administrative Management Area

6.5.1. The Administrative Management Area must be arranged separately but needs to have a convenient connection with the Technical Service Area and treatment units, must not obstruct the examination – treatment flow and not affect quietness as well as environmental sanitation.

6.5.2. The minimum area standards of functional rooms in the Administrative Management Area according to positions and titles are specified in Table 33.

Table 33 – Minimum area standards according to positions in the Administrative Management Area

6.5.3. The minimum areas of some functional rooms in the hospital are specified in Table 34.

Table 34 – Minimum areas of some functional rooms in the hospital

6.6. Logistics Technical Area and General Services

6.6.1. The scale of the car parking garage depends on the scale of each hospital. The area of the car parking garage is specified as follows:

– Spare parts and lubricant storage: from 12 m²/car to 15 m²/car;

– Driver’s duty rest room: from 9 m²/room to 12 m²/room;

– Car wash station.

6.6.2. The area standards for motorcycle, bicycle, and car parking are specified as follows:

– 0.9 m²/bicycle;

– 3.0 m²/motorcycle, scooter;

– 25 m²/car.

6.6.3. In the hospital, a machine, electricity, and water repair workshop is arranged, including a backup generator and a general machine repair team. The areas of storage and workshops are specified in Table 35.

Table 35 – Areas of storage and workshops

6.6.4. The hospital’s duty and security room is designed with an area of 6 m²/person. If there is a requirement for night duty, it is allowed to design a sleeping area according to the number of people on duty, with an area standard of 9 m²/person.

6.6.5. In the hospital, it is necessary to arrange public telephone booths with an area of 6 m²/booth, currency exchange counters and convenience stores, etc. to serve visitors and patients’ families.

6.6.6. The minimum areas of sections in the General Services area are shown in Table 36.

Table 36 – Minimum areas of sections in the General Services area

7. Technical system design requirements

7.1. Structural design requirements

7.1.1. The building structure must ensure stability, be easy for construction and renovation when necessary.

7.1.2. Construction technology and materials used must ensure safety, feasibility, meet the requirements of space organization, architectural aesthetics and functions of the hospital.

7.2. Water supply and drainage system design requirements

7.2.1. Water supply

7.2.1.1. 24 hours/day water supply system according to TCVN 4513 and ensure water quality standards according to the regulations of TCVN 5502 : 2003.

7.2.1.2. The technical service rooms (testing labs, operating rooms, delivery rooms, family planning procedure rooms) must have a sterile water filtration system, ensuring quality.

7.2.1.3. The Emergency Department and Intensive Care and Poison Control Department must be supplied with clean and sterile water continuously during the day.

7.2.1.4. It is necessary to arrange storage tanks, booster pumps, compressed air stations or other booster devices. A separate distribution pipe is needed to ensure that the amount of fire fighting water is not used for other purposes. The amount of water needed for fire fighting reserve must be based on the largest amount of fire fighting water within 3 hours according to the regulations of TCVN 2622.

7.2.1.5. The water supply standard for hospitals is calculated on average 1 m3/inpatient bed/day.

7.2.1.6. Under permissible conditions, a hot water supply system can be designed but must be stated in the construction investment report, approved by the competent authority, and must ensure technical and safety requirements.

7.2.1.7. Sanitary equipment and pipes must be suitable with the function and scale of the building, not get dirty and easy to clean, not leak and fully drain water, not generate odors, easy to install and replace.

7.2.2. Drainage

7.2.2.1. The surface water drainage system is designed according to the principle of gravity flow, collection sewers (combined with covered trenches) following the provisions in TCVN 4474.

7.2.2.2. The rainwater and domestic wastewater drainage systems are arranged separately.

7.2.2.3. Domestic wastewater and infected wastewater must be treated before flowing into the common system.

7.2.2.4. The wastewater treatment system must be designed to ensure the wastewater quality according to the provisions in TCVN 7382 : 2004 and TCVN 6772 : 2000 before flowing into the area’s drainage system.

7.2.2.5. The drainage system in the Emergency Department and Intensive Care and Poison Control Department must be a closed drainage system and ensure environmental sanitation. Wastewater is led to the hospital’s common drainage system.

7.3. Electrical – lightning protection design requirements

7.3.1. The power supply system must be designed synchronously, ensure safety, operate 24 hours/day, with sufficient capacity to operate equipment and artificial lighting according to current regulations.

7.3.2. The backup power supply system for emergencies ensures 50% to 60% of the load and must ensure constant electricity for the following rooms and sections:

– Emergency Department; Intensive Care Department – Poison Control

– Surgery Department – Anesthesia and Resuscitation;

– Delivery room, neonatal care;

– Refrigerators of testing departments;

– Blood collection and storage room of the blood bank;

– Fire fighting water pump station;

– Emergency lighting and exit guidance system;

– Special elevators for evacuation or easy fire fighting.

7.3.3. The backup power supply time for medical equipment and lighting must not exceed 15 s from the time of power failure from the national grid.

7.3.4. The lightning protection system for the building must comply with the provisions in TCVN 9835 : 2012.

7.3.5. Wiring inside the building must be placed in technical boxes and arranged hidden inside the structure. Circuit breakers and automatic switches need to be arranged in each room to ensure safety.

7.3.6. Electrical equipment must have an independent class II grounding system.

7.3.7. Electrical outlets must be installed at a height not lower than 0.6 m from the ground surface.

7.4. Lighting design requirements

7.4.1. The lighting electrical system must be independent from the power electrical system.

7.4.2. Artificial lighting must ensure the principle of energy saving.

7.4.3. Waiting halls, reception, registration areas, number taking and result receipt/return areas, support areas and corridors should use a combination of natural and artificial lighting methods.

7.4.4. The lighting standards for areas in the hospital must ensure the requirements specified in Table 37.

Table 37 – Minimum illuminance for areas in the hospital

7.4.5. The night lighting system in patient rooms needs to ensure an illuminance of 5 lux on the horizontal surface 0.8 m above the floor. The lights must be arranged lower than the bed surface, not cause glare to patients and be controlled separately from other lighting systems. The night lighting system in pediatric patient rooms must ensure an illuminance of 20 lux.

7.4.6. The design of natural lighting for buildings with a central corridor (with a length not exceeding 20 m) can take light from all sides. Central corridors longer than 40 m must be lit from two sides and have a light well not smaller than 3 m, 20 m to 25 m from the end.

7.4.7. The area of natural lighting windows must ensure the following regulations:

– For patient and staff rooms: not less than 20% of the floor area;

– For support rooms: not less than 15% of the floor area.

7.4.8. For the window opening direction of the main rooms in the hospital, refer to Appendix K.

7.4.9. In the hospital, there must be an emergency lighting system with an illuminance value not less than 5% of the illuminance value specified in Table 37 and ensuring the following regulations:

– Not less than 2 lux for the indoor emergency lighting system;

– Not less than 1 lux for the outdoor emergency lighting system.

7.5. Ventilation – air conditioning system design requirements

7.5.1. When designing the ventilation and air conditioning system for the hospital, it is necessary to have reasonable technological solutions, architectural and structural solutions to ensure sanitation requirements, comply with the provisions in TCVN 5687 : 2010 and ensure the building uses energy efficiently [9].

7.5.2. It is necessary to design mechanical ventilation for laboratories that generate toxic fumes, gas-dust mixtures with fire and explosion hazards or have furnaces.

NOTES:

1) For laboratories that emit toxic fumes, arrange local fume extraction using fume hoods. The toxic fume discharge must be arranged in a well-ventilated place that does not affect working or living people.

2) The number of air changes in the room is calculated according to the allowable concentration of toxic fumes in the room and the amount of excess heat released.

7.5.3. Ceiling fans and mechanical ventilation systems must be designed for departments and rooms in the hospital.

7.5.4. Waiting halls, reception, registration areas, number taking and result receipt/return areas, support areas and corridors should use both natural and artificial ventilation methods.

7.5.5. The air-conditioned area needs to be distributed according to conditions and have an appropriate operating time depending on the function of each room.

7.5.6. Temperature and humidity in the hospital are specified in Table 38.

Table 38 – Specified temperature and humidity in the hospital

7.5.7. The ventilation system in the area of operating rooms, delivery rooms, neonatal rooms, and sterile rooms must ensure relevant current regulations.

7.6. Medical gas system design requirements

Medical gas should be designed according to a central system in compliance with the regulations of the health sector.

7.7. Low-voltage electrical system design requirements

7.7.1. The types of low-voltage electrical systems arranged in the hospital include:

– Telephone system (external, internal);

– Public address system (internal);

– Fire alarm, emergency and security signal system;

– Alarm bell, call bell, surveillance camera system;

– Television system;

– Screen connection system, internal network;

7.7.2. It is necessary to design a synchronous communication system, Internet network, radio, television and comply with the provisions of relevant specialized standards, meeting the current and future development usage capacity.

7.7.3. The design and installation of communication systems, Internet networks, radio, and television must ensure safety, convenience for exploitation and connection with service providers, have the ability to replace and repair, and must ensure distance to other technical pipelines.

7.7.4. It is necessary to design an internal public address and television system, emergency exit guidance at the reception area, Outpatient Department, Surgery Unit, resuscitation unit and an alarm bell and call bell system for staff in patient rooms.

7.7.5. In the Intensive Care room, there should be a camera and monitor system to monitor the patient’s condition.

7.7.6. Depending on special requirements, design an information system (image and data transmission) from the operating room to the outside and administrative and training rooms to serve scientific research and teaching purposes.

7.7.7. It is necessary to design and install signage (text, images, sound, electronic) at appropriate locations.

7.8. Fire prevention and fighting design requirements

7.8.1. When designing for fire prevention and fighting, it must comply with the provisions in TCVN 2622, ensure fire safety for buildings and constructions [10] and must be approved by the competent authority.

For high-rise general hospitals, refer to TCVN 6160.

7.8.2. The minimum fire resistance of building components and materials is specified in current standards on fire prevention and fighting for buildings and constructions.

7.8.3. The maximum distance from the room doors to the nearest emergency exit must ensure:

– Rooms between two emergency exits: not greater than 30 m;

– Rooms with exits to dead-end corridors: not greater than 25 m;

NOTE: For large spaces and long corridors, depending on requirements, it is necessary to arrange fire doors to ensure safety.

7.4.8. There must be sufficient access from the outside for fire fighting equipment to approach the building and be used effectively.

Roads for fire trucks and specialized fire fighting vehicles must meet the following requirements:

– The width of the road surface is not less than 4.0 m for each lane, The height of the static clearance is not less than 4.25 m;

– Dead-end roads used for one lane must not be longer than 100 m, at the end of the road there must be a turning area. The dimensions of the turning area are specified as follows:

+ Equilateral triangle with sides not less than 17 m, one vertex on the dead-end road, two vertices symmetrically on both sides of the road;

+ Square with sides not less than 15 m;

+ Circle, diameter not less than 15 m;

+ Rectangle perpendicular to the dead-end road, symmetrical on both sides of the road, with dimensions not less than 5 m x 20 m.

7.8.5. In case of arranging 2 staircases in the same hall, one staircase must have a direct exit to the outside.

7.8.6. Corridors, vestibules, halls must be equipped with a ventilation and smoke extraction system. The components of this system must be made of non-combustible materials.

7.8.7. When the staircase is used in combination as an emergency exit, the stairwell must be an enclosed stairwell, using fire-resistant materials with a 2-hour fire resistance limit and must have fire doors and a pressurized smoke control fan system. The pressurized smoke control fan must ensure a positive pressure of 20 Pa on the wall surface to prevent smoke from spilling into the staircase and make it easy to close the fire doors.

7.8.8. It is necessary to design signs at emergency exits, places that are prone to danger and be illuminated with an illuminance of not less than 1 lux for at least 1.5 hours to ensure safe use and evacuation.

7.9. Requirements for solid medical waste collection

7.9.1. Different types of waste must be contained in different bags/bins. These bags and bins must follow a color-coding system to avoid mixing different types of waste with each other.

7.9.2. Waste classification must be performed right at the source of generation.

7.9.3. Waste must be collected daily or regularly transported out of departments and rooms.

7.9.4. Waste can be centrally treated and destroyed right within the hospital or transported to other treatment sites outside the hospital.

7.9.5. There must be a separate place for classified solid waste to be collected, transported and treated in compliance with regulations on medical solid waste management [6].

7.10. Building finishing requirements

7.10.1. Floor

7.10.1.1. The floor surface must be flat, smooth, ensure non-slip, waterproof and easy to clean. In some other areas, the floor surface must also meet the following requirements:

– Imaging room, X-ray room: must be antistatic, ensure radiation safety;

– Functional rooms in the Emergency Department, Intensive Care and Poison Control Department: must be resistant to chemicals, antibacterial and antistatic;

7.10.1.2. The joint between the floor and the wall must be easy to clean and dust-proof.

7.10.2. Wall

7.10.2.1. The wall surface must be painted or lime-washed to ensure hygiene and aesthetics.

7.10.2.2. The inner wall surface with hygiene and frequent cleaning requirements must be painted or use materials that ensure waterproofing and chemical corrosion resistance to a minimum height of 2.0 m from the floor.

7.10.2.3. The inner wall of the X-ray room must use radiation-shielding materials, ensuring ionizing radiation safety according to the provisions of TCVN 6561 and TCVN 6869.

7.10.2.4. The inner walls of emergency holding rooms, intensive care and poison control rooms, interventional procedure rooms, operating rooms must be finished with waterproof, chemical-resistant, antibacterial, easy-to-clean materials from floor to ceiling.

7.10.2.5. The inner walls of the corridor area with stretcher, vehicle and bed transportation must have impact-resistant bars at a height of 0.7 m to 0.9 m from the floor.

7.10.3. Ceiling

7.10.3.1. The ceiling surface must be flat, smooth, dust-proof, ensure thermal insulation, sound insulation, and waterproofing.

7.10.3.2. The inner ceiling of rooms and corridors of the Emergency Department and Intensive Care and Poison Control Department, Surgery Department – Anesthesia and Resuscitation must have a flat, smooth, dust-proof, antibacterial, insulated and waterproof surface.

7.10.3.3. Rooms and corridors must have a technical ceiling for installing lighting equipment, fire fighting equipment, air conditioning and other technical equipment.

7.10.3.4. The inner ceiling of the X-ray room must use radiation-shielding materials to ensure ionizing radiation safety in accordance with the provisions of TCVN 6561 and TCVN 6869.

7.10.4. Doors

7.10.4.1. Dimensions ensure usage requirements.

7.10.4.2. The operating room, delivery room, emergency room, intensive care room must be designed with double-leaf doors, two-way hinges or automatic opening and closing and must have safety locks.

7.10.4.3. The main emergency exit doors of building blocks and crowded areas must be designed to open outwards.

7.10.4.4. Hall doors and triage room doors can be designed as automatic opening and closing type.

7.10.4.5. Main doors with vehicle and bed transportation use two-way hinged doors.

7.10.4.6. X-ray rooms must be designed with sliding doors with hanging rails, ensuring ionizing radiation safety, ensuring tightness to prevent radiation leakage during fluoroscopy and imaging. There must be radiation warning lights and signs outside the imaging room.

7.10.5. Windows

7.10.5.1. There must be a protective iron bar system and insect screens (if needed).

7.10.5.2. Rooms with X-ray equipment, CT scanners and MRI machines must not be designed with windows.

7.10.6. Interior and exterior

7.10.6.1. Interior and exterior design must meet the following requirements:

– Synchronized with technology, equipment and load-bearing structure;

– Suitable for the psychology of patients and staff;

– Durable and convenient for regular sanitation and maintenance;

– Having measures to prevent termites and insects for the building.

7.10.6.2. Trees and gardens outside must be designed and planned in accordance with the shape, function and usage of the building such as reception yard, walking garden, green belt, lawn isolation, traditional medicine garden, etc.

– Planting trees and lawns in empty spaces to create a microclimate environment, isolating the Infectious Diseases Department, Infection Control Department, Nutrition Department and Autopsy House from other building blocks.

– Not planting trees with toxic sap, thorns and fruits that attract insects.

– There must be a wide transition of 1.2 m to 1.5 m at the entrance from the yard and garden with tiles to avoid bringing dust and dirt inside the building.

– Natural and landscaped ponds and lakes must not be used as wastewater storage.

Appendix A (for reference) Functional zoning diagram of a General Hospital

Figure A.1 – Functional zoning diagram of a General Hospital

Appendix B (for reference) General Outpatient Department and Outpatient Treatment

Figure B.1 – Flow diagram of the General Outpatient Department and Outpatient Treatment

Figure B.2 – Flow diagram of Internal Medicine Examination and Treatment

Figure B.3 – Flow diagram of Surgical Examination and Treatment

Figure B.4 – Flow diagram of Ophthalmology Department

Figure B.5 – Flow diagram of ENT Department

Figure B.6 – Flow diagram of Oral and Maxillofacial Surgery Department

Figure B.7 – Emergency operation flow diagram

Figure B.8 – Functional flow diagram of Traditional Medicine Department

Figure B.9 – Flow diagram of Physical Therapy – Rehabilitation Department

Appendix C (for reference) Inpatient Treatment Area

Figure C.1 – Flow diagram of the Inpatient Treatment Area

Figure C.2 – Flow diagram of the inpatient treatment area of the Obstetrics and Gynecology Department

Appendix D (for reference) Technical Service Area

Figure D.1 – Flow diagram of the Surgery Department – Anesthesia and Resuscitation

Figure D.2 – Operating room

Figure D.3 – Clean air system for operating room

Appendix E (for reference) Diagnostic Imaging Department

Figure E.1 – Flow diagram of the Diagnostic Imaging Department

Figure E.2 – CT-SCANNER room

Figure E.3 – General X-ray room

Figure E.4 – Interventional X-ray room

Figure E.5 – MRI room

Figure E.6 – Dark room, classification room

Appendix G (for reference) Testing, Blood Transfusion, Dialysis, Pathology Departments

Figure G.1 – Functional flow diagram of the Testing Department

Figure G.2 – Flow diagram of the Microbiology Department

Figure G.3 – Flow diagram of the Biochemistry Department

Figure G.4 – Flow diagram of the Hematology Department

Figure G.5 – Flow diagram of the Blood Transfusion Department

Figure G.6 – Flow diagram of the Dialysis Department

Figure G.7 – Flow diagram of the Pathology Department

Appendix H (for reference) Endoscopy, Function Testing, Pharmacy Departments

Figure H.1 – Flow diagram of the Endoscopy Department

Figure H.2 – Functional flow diagram of the Function Testing Department

Figure H.3 – Functional zoning diagram of the Pharmacy Department

Appendix I (for reference) Nutrition Department, Infection Control Department

Figure I.1 – Diagram of the Nutrition Department

Figure I.2 – Flow diagram of the Nutrition Department

Figure I.3 – Flow diagram of the Laundry Section of the Infection Control Department

Appendix K (regulation) Natural lighting requirements

Table K.1- Window opening direction of the main rooms in the hospital

REFERENCE LIST

[1] Hospital regulations, Decision No. 1895/1997/QD-BYT dated September 19, 1997 of the Ministry of Health.

[2] QCVN 03:2009/BXD, National technical regulation – Classification and grading of civil, industrial and urban technical infrastructure construction works.

[3] QCXDVN 01 : 2002, Vietnam construction regulation – Construction of buildings to ensure accessibility for people with disabilities.

[4] QCXDVN 05:2008/BXD, Vietnam construction regulation – Residential buildings and public works – Life safety and health.

[5] QCXDVN 01:2008/BXD, Vietnam construction regulation – Construction planning;

[6] Regulations on medical waste management, Decision No. 43/2007/QD-BYT dated November 30, 2007 of the Ministry of Health.

[7] Decision No. 147/1999/QD-TTg dated July 5, 1999 of the Prime Minister regulating standards and norms for using office space in state agencies and non-business units,

[8] Circular 23/2005/TT-BYT dated August 25, 2005 of the Ministry of Health guiding the classification of health non-business units.

[9] QCXDVN 09:2005/BXD, Vietnam construction regulation – Construction works using energy efficiently.

[10] QCVN 06:2010/BXD, National technical regulation – Fire safety for buildings and constructions.

(1) TCVN and about to be promulgated

(2) TCXDVN is being converted