TCVN 9214:2012 Polyclinic – Design standard

Foreword

TCVN 9214:2012 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 of application

This standard applies to the design of new, renovated and upgraded regional general clinics nationwide.

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 4470:2012[1], General hospital – Design standard.

3. Terms and definitions

This standard uses the terms and definitions given in TCVN 4470:2012 and the following terms and definitions:

3.1. Regional general clinic

A place that carries out primary health care activities, provides medical services: disease prevention, examination – treatment, outpatient treatment, treatment of common diseases and some specialized diseases.

3.2. Examination and outpatient treatment area

An area for receiving, examining, diagnosing, classifying and providing initial treatment for patients under the scope of responsibility, performing outpatient treatment and guiding primary health care.

3.3. Treatment area

A place for examination and treatment according to the characteristics of each specialty, divided into independent specialties for management and treatment.

3.4. Patient temporary holding area

A treatment area for patients who need to be monitored, severely ill patients waiting to be transferred to a higher level.

4. General provisions

4.1. Regional general clinics have a service radius of 10 km to 15 km.

4.2. The design and construction of regional general clinics must ensure safety, durability, suitability, aesthetics, conformity with natural climate conditions and meet usage needs, ensure environmental hygiene.

4.3. The design and construction of regional general clinics must be suitable to the local socio-economic conditions, corresponding to the management level while considering the ability to expand, adjust and renovate in the future.

4.4. The design and construction of regional general clinics must ensure accessibility for persons with disabilities, ensure life safety and health according to current regulations [1], [2].

5. Requirements for construction land and general site planning

5.1. Requirements for construction land

5.1.1. The location of the construction land is convenient for connecting inter-commune and inter-district traffic, residential areas and in line with the general planning.

5.1.2. The construction land must have good environmental sanitation conditions, sufficient and regular clean water supply, ensure hygiene and other technical utilities related to the construction.

5.2. Requirements for general site planning

5.2.1. The maximum building density and the minimum greenery density must comply with construction planning regulations [3].

5.2.2. The scale of the regional general clinic and the minimum land area criteria are specified in Table 1.

Table 1 – Scale and minimum land area criteria for constructing regional general clinics

Scale	Number of patient beds beds	Number of examinations per day visits	Minimum land area ha
Large	from 11 to 15	from 120 to 150	0.24
Small	from 6 to 10	from 80 to 120	0.20

6. Construction content and design solutions

6.1. Regional general clinics include:

Examination and outpatient treatment area;
Treatment area;
Patient temporary holding area;
Administration – Technical logistics area;
Auxiliary area.

6.2. Requirements for internal dimensions

6.2.1. Room height

6.2.1.1. The minimum internal height of the rooms in the regional general clinic is regulated at 3.0 m and can be changed according to the requirements of each room in the clinic.

6.2.1.2. The internal height of bathrooms, toilets, and dirty object storage rooms is not less than 2.4 m.

6.2.2. Corridor dimensions

Width of the central corridor: not less than 2.4 m;
Width of the central corridor (with movement of stretchers, combined with waiting area): not less than 3.0 m;
Width of the side corridor: not less than 1.5 m;
Width of the side corridor (with movement of stretchers, 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 the corridor in the hospital to assist persons with disabilities and patients. The installation height of handrails is from 0.75 m to 0.8 m.

6.2.3. Door dimensions

Height of door: not lower than 2.1 m;
Width of single door: not less than 0.9 m;
Width of double door: not less than 1.2 m;
Width of the main door to minor surgery, delivery, emergency rooms: not less than 1.6 m;
Width of the main door of radiography room: not less than 1.4 m;
Width of toilet door: not less than 0.8 m.

6.2.4. Dimensions of stairs and ramps

The design of stairs must ensure regulations on life safety and health [2] for users and meet the following requirements:

Width of each staircase: not less than 1.5 m;
Width of staircase landing: not less than 1.5 m;
Slope of ramp: not greater than 1:10;
Width of ramp: not less than 2.1 m;
Width of ramp landing: not less than 2.4 m;
At the main entrance and exit there must be a ramp for persons with disabilities with a width not less than 1.2 m.

6.3. Examination and outpatient treatment area

6.3.1. The minimum area of the rooms in the Examination and outpatient treatment area is specified in Table 2.

6.3.2. The number of waiting seats for patients and relatives is calculated at the rate of 25% to 30% of the total number of examinations per day with an area criteria of 1.6 m²/seat.

Table 2 – Minimum area of rooms in the Examination and outpatient treatment area

Room type	Minimum area
Room type	Small scale from 6 beds to 10 beds	Large scale from 11 beds to 15 beds
1. Internal medicine examination – treatment	18 m²/seat x 1 examination seat	18 m²/seat x 2 examination seat
2. Surgical examination – treatment	12 m²/seat x 1 examination seat	12 m²/seat x 2 examination seat
3. Minor surgery room	from 18 m²/room to 24 m²/room
4. Pediatric examination – treatment	12 m²/seat x 1 examination seat	12 m²/seat x 2 examination seat
5. Obstetric examination	15 m²/seat x 1 examination seat	15 m²/seat x 1 examination seat
6. Gynecological examination	15 m²/seat x 1 examination seat	15 m²/seat x 1 examination seat
7. Dental – Maxillofacial, Otolaryngology and Ophthalmology examination – treatment	8 m²/seat x 3 examination seats- 1 dental chair- 1 ENT chair- 1 ophthalmology chair	8 m²/seat x 3 to 4 examination seats- 2 dental chairs- 1 ENT chair- 1 ophthalmology chair
8. Examination and treatment according to traditional medicine	18 m²/seat x 1 examination seat	18 m²/seat x 1 examination seat
9. Management – treatment, monitoring of social diseases	9 m²/ desk	9 m²/ desk
10. Testing	15 m²/ 03 testing tables	15 m²/ 03 testing tables
11. Diagnostic imaging
– Machine room^a)	20 m²/machine	20 m²/machine
– Control room	6 m²/room	6 m²/room
– Film processing room	18 m²/room	18 m²/room
– Ultrasound	9 m²/machine x 01 machine	9 m²/machine x 02 machine
– Auxiliary room	–	9 m²/room
12. Functional exploration
– Gastrointestinal endoscopy	–	24 m²/room x 01 room
– Electrocardiogram	18 m²/room x 01 room	24 m²/room x 01 room
NOTE: ^a) If the X-ray machine has an X-ray room design from the manufacturer attached, the minimum room size must not be smaller than the size specified by the manufacturer and not less than the above area standard..

6.4. Treatment area

6.4.1. The minimum area of the rooms in the Treatment area is specified in Table 3.

6.4.2. The rooms in the Treatment area must have a convenient relationship with each other and with the Administration – technical logistics area.

6.4.3. Each regional general clinic must have at least one emergency room that meets the area criteria specified in Table 3.

6.4.4. The family planning procedure room must have a separate waiting area.

Table 3 – Minimum area of rooms in the Treatment area

Room type	Minimum area
1. Emergency	24 m²/emergency seat
2. Minor surgery	15 m²/minor surgery table
3. Delivery room ^a)	15 m²/delivery table
4. Family planning services	15 m²/procedure table
NOTE: ^a) Includes: 01 delivery table and 01 newborn reception table, 01 instrument table and sink.

6.5. Patient temporary holding area

6.5.1. The minimum area of patient temporary holding rooms is specified in Table 4.

Table 4 – Minimum area of patient temporary holding rooms

Room type	Minimum area
Room type	Small scale from 6 beds to 10 beds	Large scale from 11 beds to 15 beds
1. Regular patient ^a)	6 m²/bed x 02 to 04 beds	6 m²/bed x 05 to 09 beds
2. Infectious patient ^b)	6 m²/bed x 01 to 02 beds	6 m²/bed x 02 beds
3. Emergency patient ^b)	6 m²/bed x 01 to 02 beds	6 m²/bed x 02 beds
4. Maternity patient ^c)	15 m²/02 beds
NOTE: ^a) Separate male/female patient rooms; ^b) If the infectious patient and emergency patient rooms in small-scale regional general clinics only have 01 temporary bed, the room area must not be less than 18 m²; ^c) Includes the area of a private sanitary section with an area criteria of 3 m² to 4 m².

6.5.2. Patient rooms should have private sanitation.

6.5.3. Infectious patient rooms must have isolation solutions.

6.5.4. Emergency patient rooms must be arranged adjacent to the emergency room.

6.6. Administration – Technical Logistics Area

6.6.1. The minimum area of the rooms in the Administration – Technical Logistics Area is specified in Table 5.

6.6.2. The waiting lobby and reception area should be arranged adjacent to the propaganda and consulting room.

6.6.3. The medical administration area must be arranged adjacent to the waiting lobby.

6.6.4. The instrument washing, sterilizing and drying room must be arranged adjacent to the Examination and outpatient treatment area.

Table 5 – Minimum area of rooms in the Administration – Technical Logistics Area

Room type	Minimum area (m²/room)
	Small scale from 6 beds to 10 beds	Large scale from 11 beds to 15 beds
1. Waiting lobby, reception	from 18 to 24
2. Propaganda, consulting	from 18 to 24
3. Reception	from 18 to 24
4. Administration, medical	from 15 to 18
5. Clinic head	18
6. Staff on duty	12	15
7. Pharmacy and equipment	12	15
8. Instrument washing, sterilizing and drying	12	12

6.7. Auxiliary Area

6.7.1. The minimum area of the rooms in the Auxiliary Area is specified in Table 6.

Table 6 – Minimum area of rooms in the Auxiliary Area

Room type	Minimum area
	Small scale from 6 beds to 10 beds	Large scale from 11 beds to 15 beds
1. Service (kitchen, cooking)	12 m²/room	15 m²/room
2. Staff sanitation, bathing, changing clothes ^a)	20 m²/area (01 toilet, 02 urinals, 01 sink, 01 shower) x 02 areas	32 m²/area (02 toilets, 03 urinals, 01 sink, 02 showers) x 02 areas
3. Staff parking areas	Divided into two separate areas with area criteria of 0.9 m²/bicycle; 3.0 m²/motorcycle; 25 m²/car
4. Patient and visitor parking areas
5. Duty, security	9 m²/room x 01 room
NOTE: ^a) The sanitation area is designed separately for male/female;

6.7.2. The car parking area is not placed close to the Examination and outpatient treatment area and the Patient temporary holding area.

7. Requirements for technical system design

7.1. When designing the technical system of the Regional general clinic, it is necessary to comply with the provisions stated in Article 7 of TCVN 4470:2012 and the provisions in this standard.

NOTE: Regional general clinics have no requirement for the design of medical gas systems and low voltage systems.

7.2. The water supply standard for regional general clinics is calculated on average from 20 m³/day-night to 30 m³/day-night.

7.3. The lighting system of the areas in the regional general clinic must ensure the requirements specified in Table 7.

Table 7 – Minimum illuminance in regional general clinics

Area	Minimum illuminance (lux)
Reception are	300
Examination room	300
Recovery room	300
Patient room	100
Delivery room	400
Common corridor	150
Diagnostic X-ray, shooting	20
Diagnostic X-ray, workplace	300
Doctor’s office	300
Staff room	100
Nurse’s room (day duty)	300
Nurse’s room (night duty)	30
Kitchen	300
Pathology testing room (on-site)	500
Warehouse	100
Bathroom	100
Sink	200
Toilet	100

7.4. The temperature of the following rooms must be ensured:

Delivery room: from 21°C to 25°C;
Pediatric room: from 24°C to 26°C.

7.5. Waste is concentrated for transportation to the treatment site outside the Regional general clinic.

Appendix A (for reference) Functional zoning diagram of the Regional general clinic

Figure A.1 – Functional zoning diagram of the Regional general clinic

REFERENCES

[1] QCXDVN 01:2002, Construction standards for buildings accessible to people with disabilities.

[2] QCXDVN 05:2008/BXD, Vietnam Building Code – Housing and Public Buildings – Life Safety and Health.

[3] QCXDVN 01:2008/BXD, Vietnam Building Code – Construction Planning;

[1]) TCVN to be issued