BUILDING DESIGN
The newly remodeled preparation room in the surgery suite.
emergency laboratory, blood bank, pharmacy, two surgery rooms with recovery area with four beds, and three rooms for staff on call. This department is connected, via elevators, with the ICU and the surgery suite, which is located in the first floor. The layout features two main corridors
with doors that separate the different sections, trying to control the traffic of people through the department, specially the relatives of patients that are allowed into the
observation unit. Children emergency: This area is located
in the second floor. Regulations require separate emergency areas for children and adults, but they do share the use of imaging equipment. This department also has two different access points – one for ambulances with direct access to the trauma room which has a capacity for three beds and another for walking patients. The trauma area is internally close with
two rooms for intermediary care – one with two beds for critical patients and other with six beds, with a nurse station integrated. The walk-in entrance has a waiting area and a treatment unit. This treatment unit has a central nurse station and a sub-waiting space. Around this area, there is a station for weight and size, four consultation rooms, and a bath for babies, a procedures room with three beds, a respiratory therapy room with seven recliner chairs, and an isolation room. Further, in a separate area with natural light, there is an observation unit with capacity for 20 beds and cribs with a psychomotor room, baths and nurse station. In all these areas, parents are allowed, and indeed encouraged,
to be with their children. Doctors residencies and staff rooms: On
this floor there is also an area designated for staff and residents. This has 12 beds for staff and 48 beds for residents that overnight in
The new surgical suite.
the hospital, with study and meeting rooms for seminars and a dining room with kitchenette as well. The bathrooms are located at the end of the area because the surgical suite is located under and, norms and regulations (MSAS, 1996) state that there should be no water installations above these critical areas. At the far end of this section, a staircase connects the doctors residence with the old hospital to avoid them having to pass
through the emergency areas. Surgical suite: The first floor of the
building holds the surgical suite, which connects directly with the ICU and inpatient rooms located in the old building through a corridor. There are eight operating rooms (OR) with a central corridor and a peripheral one to circulate the soil material that connects directly with the central sterile supply. At the suite entrance patients are transferred, from exterior to interior strollers, into the preparation room with nine beds. There is a recovery room with 16 beds. Ancillary spaces – a kitchenette, rooms for on call doctors, sanitary areas, meeting rooms, offices, and consultation area – are located outside of the restricted area close to the floor access. The remodelling of this building took six
years to complete. It began in 2007 and concluded in 2013. The first year the building was completely demolished, leaving only the structure. The structure was evaluated by seismic norms and was consequently reinforced. The problem surrounding humidity and the necessary construction of the external wall with a micropile system squeezed the budget. Construction ceased for almost a year, between 2009 and 2010, due to a lack of financial support. In mid 2010 remodelling was initiated, but with a change of contractors and in the project. The first project had included building a fourth
‘The project demonstrates the serious impact and implications on the performance of the hospital, when such a massive intervention is undertaken without proper planning.’
IFHE DIGEST 2015
floor to house the educational and resident’s facilities, but this idea was rejected in the new phase. Construction restarted in 2011 and some of the original work done had to be demolished to apply the changes made to the new project. The facility was finally finished and operations began 2013.
Conclusion The remodelling works had the effect of significantly reducing the number of operating beds in the facility. As of 2008, surgery was reduced to a minimum and shortly afterwards no surgery took place in the hospital until 2013. Surgical interventions during this period were carried out at the military hospital instead. An agreement allowed patients to be transferred to the center, operated by surgeons of the Vargas and then returned for recovery in the hospital. The project demonstrates the serious
impact and implications on the performance of the hospital, when such a massive intervention is undertaken without proper planning. The extension of the works – which lasted over five years – also had a devastating impact on the morale of staff and irreparable damage of the teams in all disciplines, with serious consequence on the quality of the services.
References 1 Godoy Oswaldo y Oletta J.F. (2013) Estadísticas del Hospital Vargas. Caracas 1999-2010. Departamento de Epidemiología y Estadística del H. Vargas.
2 Hung (2004) Estadisticas de la Direccion de Salud de la Alcaldia Metropolitana. Publish in: Cedres de Bello, Sonia (2012) Departamentos de Emergencia. Planificacion, diseño y uso. Editorial Academica Espanola. Germany. ISBN 978-3-8484-6449-4 p: 351.
3 Ministerio de Sanidad y Asistencia Social (1996) Normas Requisitos Arquitectónicos para Establecimientos de Salud. Servicio de Emergencia. Gaceta Oficial No. 465-96. Venezuela.
4 Ministerio de Sanidad y Asistencia Social (1998) Normas de funcionamiento del Servicio de Quirófanos del Sector Público y Privado. Gaceta Oficial No. 36.574. Venezuela.
37
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96