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UNIVERSITY OF NAIROBI
COLLEGE OF ARCHITECTURE AND
ENGINEERING SCHOOL OF THE BUILT
ENVIRONMENT
DEPARTMENT OF ARCHITECTURE &
BUILDING SCIENCE
A Research Thesis
Bachelor of Architecture
Submitted by: MAINA HARUN WANYEKI
BO2/0310/2009
2014/2015
TUTOR: DR KAMENJU
DECLARATION
This thesis is my original work and to the best of my knowledge has not been presented for a degree
in any other institution. Author: Maina Harun Wanyeki
Signature.
Date
This thesis is submitted in part fulfillment of the examination requirements for the award of the Bachelor of
Architecture degree, Department of Architecture and Building Science, University of Nairobi.
Signature..
Signature
Date
Date
ACKNOWLEDGEMENTS
To God almighty, for the gift of good health and mental composure that enabled me to write this
thesis with consistency.
. To my loving Parents, Mr. and Mrs. Maina, Thank you for your
continuous devotion to me through prayers, moral and financial support.
To my siblings: Regina Maina, Monica Maina and Hellen Maina, thank you for your moral support throughout
the writing of this thesis. To Dr.Muriithi, thank you for your career guidance and financial support. I would not
have joined the field of Architecture were it not for your career guidance.
To Tabitha Kiarie (department of architecture) thank you for allaying my fears in first year when I
joined the department. Your encouragement has brought me this far.
Rhoda Kaguo and Patrick Gitonga for their contribution in the data collection during the fieldwork. I wish to
particularly thank Mr.Caleb for undertaking to print this thesis document free of charge.
DEDICATION
To
Dr.Muriithi
TABLE OF CONTENTS
Declaration...................................................................................................................................................................................................... ii
Acknowledgement........................................................................................................................................................................................iii
Dedication....................................................................................................................................................................................................... iv
Table of contents............................................................................................................................................................................................v
List of figures.................................................................................................................................................................................................ix
List of tables..................................................................................................................................................................................................xii
Abstract........................................................................................................................................................................................................ 1
Chapter 1: Introduction
1.1...........................................................................................................................................Background of study 2
1.2 Problem statement.......................................................................................................................................................................... 3
1.3 Aims & Objections...........................................................................................................................................4
1.4 Research Questions.........................................................................................................................................4
1.5 Scope & Limitations........................................................................................................................................4
1.6 Justification of Study....................................................................................................................................5
1.7 Significance of Study....................................................................................................................................5
1.8 Definition of Terms..........................................................................................................................................5
1.9 Structure of the Paper..................................................................................................................................6
Chapter 2: Literature Review
2.1 Introduction.....................................................................................................................................................7
2.2 History of hospital planning.............................................................................................................................7
2.2.1 Early times..........................................................................................................................................7
2.2.2 Greece................................................................................................................................................8
2.2.3 Classical antiquity...............................................................................................................................8
2.2.4 Medieval Christian period...................................................................................................................8
2.2.5 Renaissance........................................................................................................................................8
th
th
2.2.6 18 & 19 Century.............................................................................................................................9
th
2.2.7 20 Century........................................................................................................................................9
2.3 The organisation of Health care facilities......................................................................................................10
4.0........................................................................................................................................................................Intr
oduction..........................................................................................................................................................44
4.1........................................................................................................................................................................Ke
nyatta National Hospital..................................................................................................................................44
4.1.1............................................................................................................................................................Intr
oduction...............................................................................................................................................45
4.1.2............................................................................................................................................................Cur
rent Status............................................................................................................................................46
4.1.3............................................................................................................................................................Ho
spital Services......................................................................................................................................46
4.1.4............................................................................................................................................................Pla
nning....................................................................................................................................................48
4.1.5............................................................................................................................................................Zo
ning......................................................................................................................................................50
4.1.5.1................................................................................................................................................Cli
nical Zone................................................................................................................................................................... 50
4.1.5.2................................................................................................................................................Nur
sing Zone.................................................................................................................................................................... 51
4.1.5.3................................................................................................................................................Su
pport Zone..................................................................................................................................................................51
4.1.6 Circulation...........................................................................................................................................53
4.1.6.1................................................................................................................................................Acc
ess..................................................................................................................................................................................53
4.1.6.2................................................................................................................................................Se
paration of Dissimilar Traffic................................................................................................................................ 55
4.1.6.3................................................................................................................................................Int
ernal circulation........................................................................................................................................................56
4.1.6.4................................................................................................................................................Ea
se of wayfinding....................................................................................................................................................... 56
4.1.6.5................................................................................................................................................Cir
culation spaces......................................................................................................................................................... 57
4.1.6.6
Communication spaces...................................................................................................................................57
4.1.7
Flexibility & growth.............................................................................................................................59
4.1.7.1
The Old Hospital.....................................................................................................................................................59
4.1.7.2
Phase 1......................................................................................................................................................................63
4.1.7.3
Phase II......................................................................................................................................................................65
4.1.7.4
Phase III..................................................................................................................................................................68
4.1.8
A& E wing.............................................................................................................................................67
4.1.9
The nursing tower...............................................................................................................................70
4..1.10 Emergency design features in the nursing tower..........................................................................74
4.1.11........................................................................Comparison of the Horizontal typology models at KNH
77
4.1.12..............................................................plannning & design challenges at Kenyatta national hospital
79
4.2 Nanjing Drum Tower Hospital.............................................................................................................81
4.2.1...........................................................................................................................................Introduction
81
4.2.2......................................................................................Nanjing Drum Tower Hospital South Extension
...........................................................................................................................................................82
4.2.3Sustainable design features in the hospital.....................................................................................83
4.2.4........................................................................The Planning & design of Nanjing Drum Tower hospital
...........................................................................................................................................................85
4.2.4.1............................................................................................................................................Zoning
.....................................................................................................................................................93
4.2.4.2......................................................................................................................................Circulation
.....................................................................................................................................................94
4.2.4.3.........................................................Emergency design features at Nanjing Drum tower hospital
.....................................................................................................................................................96
4.3. Comparison of KNH & Nanjing drum tower hospital....................................................................................97
Chapter five: conclusions and recommendations
5.1.........................................................................................................................................................Introduction
100
LIST OF FIGURES
Chapter 1: Introduction
Figure 1-1: A diagram illustrating the horizontal and vertical
planning strategies in hospital design .pg2
Figure 1-2: vertical planning strategy in hospital
design.pg3 Figure 1-3: Horizontal planning strategy
in hospital design.pg3 Figure 1-4: Rush University
Medical Center, Chicago, and USA.pg4 Figure 1-5:
Aerial view of Mbagathi District hospital.pg4
Figure 1-6: National Cancer Center Tokyo, Japan (361
feet).pg5
Figure 1-7: The southwest hospital surgery tower in
Chongqing, china.pg5 Figure 1-8: Hervey Hospital,
Denmark.pg6
Figure 1-9: Queen Mary Hospital, Hong Kong.pg6
xi
i
xi
ii
th
th
LIST OF TABLES
Table 3-1: Table of study parameters.................................................................................................................................................................... 41
Table 4-1: Comparative analysis table of the horizontal hospital typologies at Kenyatta National Hospital........................77
Table 4-2: Comparative analysis table of Kenyatta National Hospital (Kenya) & Nanjing Drum Tower Hospital (China)......97
ABSTRACT
Hospitals may be thought of as icons of pain, sickness and distress, but they are also icons of healing, life,
family and hope. They are therefore important buildings for any community. The planning and design of
hospitals has a great impact on the stress levels (to staff & visitors) and to the patients recovery period.
The main factor which differentiates hospitals from other buildings is that no other building type presents
such a diverse spectrum
of occupants with varying physical and emotional needs. The hospital is
therefore a complex building type. A deep understanding of the inter-relationship of the parts and their
relationship in-turn to the whole hospital is required to make a meticulous healing environment.
Hospital planning can be grouped into two types; the horizontal hospital and the vertical hospital. The
success of these two types cannot be overstated; however they are characterized by their own unique
challenges. Its precisely because of the limitations exhibited in the two hospital types and their typologies
that a conceptual framework is needed to clearly understand the creation of a proper healing environment.
Versus
Definition of terms
Figure 1-9: Queen Mary Hospital, Hong Kong Bed capacity-1,400 beds
Year Built-1991
Source: Source: , August 3rd 2014
Early Times
In the early 3rd century B.C, medicine and healing were linked to the
gods. Consequently, the hospital forms that existed closely
resembled the forms of the temple. The temples enshrining these
gods became centres of healing, although in a basic manner with
priests as medical consultants (Rosenfield & Rosenfield, 1969).
2.2.2
Greece
th
By the end of 6 century B.C, medical clinics had developed in
Greece to complement the temples that acted as healing centres.
The Greek physicians who were free citizens held consultations
and treated their private patients. These clinics were eventually
private institutions but the state funded similar institutions to
provide health care to the citizens.
2.2.3
Classical Antiquity
According to Rosenfield & Rosenfield (1969), Later in Classical
antiquity, the rational processes of thought were reflected in the
plan form which gradually achieved a character of its own. The
Figure 2-3: The priest medieval consultant of classical Greeceorder and clarity became evident, Clear patterns of circulation
Source: Rosenfield. (1969) Hospital architecture and beyond,
were delineated and attention paid to functional groupings.
July 5th 2014
2.2.4
2.2.5
Renaissance
In Italy, Renaissance brought back a certain rational clarity to the
plan form. Orderliness and careful attention to circulation was
demonstrated but the Alter was still the focal point.
2.2.6
th
th
th
20 Century
As from the 20th century to the present day, the architectural
form of the hospital has changed from the low horizontal pavilions
to a vertical hospital. The vertical
10
Clinical zone
2. Nursing zone
3. Support zone
zone
11
2.4.2
Clinical zone
This is the working area for medical treatment and observation.
The clinical zone should be located on the most accessible floor
from the street or road, from the inpatients quarters and from the
outpatient clinics. It comprises of various departments needed for
medical treatment and observation. Of importance to note in the
clinical zone is:
12
The support zone is the third main section of the hospital. Its
purpose is to satisfy all the physical and material needs of the
nursing and clinical zones. Such needs include: food, energy,
goods and services. It has to provide for the reception, handling,
distribution, storage and disposal of everything that comes into
and goes out of the hospital (Wheeler, 1964).
2.4.4
zone
13
rooms are often old and infirm, that they may require assistance
in walking and that parking spaces for these people should be as
close as possible to the entrance.
2.5.2
in
its
own
right
.
2.5.4Anticipate change
1
6
2.5.6Energy conservation/sustainability
Studies have concluded that a natural environment is essential
to creating a genuine state of the art-healing environment
(AECOM, 2012). Spending time in outdoor places of respite has
been shown to reduce stress (important for staff and visitors)
and views to nature have been credited with reduced pain
levels and a shorter stay in hospitals. This would entail:
18
2.6.1
Figure 2-24: space for
2 bed
s passing
Source: hospital
es, 2013
building not
Access
Figure 2-25: corridor with recess for turning bed through 180
Source: hospital building notes, 2013
The accident and Emergency (A&E) department will need its own
entrance because It is open 24hours and since there are clinical
and aesthetics reasons for not allowing accident traffic to mix
with outpatient and visitors. The entrance to the emergency
service should be shielded from sight of the main hospital
entrance. It should have space for unloading about 3 vehicles
simultaneously and there should be parking space where waiting
cars can be parked without obstructing access and
maneuverability in front of the entrance. The door opening to the
Accident and Emergency department should be wide enough
(1800 min) to permit a stretcher with attendants and even
transfusion apparatus to pass through with ease and dispatch.
Provision space for wheelchairs and wheel stretchers should be
made at the entrance.
2.6.2
Corridors
20
2.6.3
Lifts
2.6.4
Privacy
Figure 2-29: Ramp for the physically challenged. Source: Metric planning handbook
2
1
2
2
Tatton-Brown, 1986).
Versus
24
2.9.1
Figure 2-33: Khon Kaen university hospital, Thailand Source: Author modified sketch,
st
July 21 2014.
2
5
2
6
2.9.3
-Natural light
-Landscaped courtyards
-Domestic scale
of evacuation in case of fire
-Ease
-Provision
for future extension
-Simple
load bearing structure
27
Natural lighting
Landscaped courtyard providing places of rest and natural
ventilation
Figure 2-38: Horizontal monolith hospitals. Source: Author modified sketch,
Julyof21st
2014
Ease
evacuation
in case of emergency
Simple load bearing
However this hospital type is inflexible to future extension and
growth
2.10
Figure 2-41: New York Presbyterian Hospital. The neo-gothic structure stands 376 feet (114.6 meters) high
Source , July 21st 2014
29
30
2.10.2
Figure 2-44: complex tower on podium Source: Author modified sketch, July 24 th 2014
31
32
2.10.4
This type of hospital has more than one tower rising from the
podium but these towers are linked and share one central
vertical circulation. Each tower houses one particular zone of
activity, either nursing or clinical only; usually the nursing tower
rises highest.
Example: The
bunting centre
Architects: AECOM
Figure 2-48: Articulated slabs on podium Source: Author modified sketch , July 25th 2014
33
Figure 51: Kenyatta national hospital nursing tower block Source: Author, 22nd August 2014
3
4
Collection Methods
3.5.1
Primary data
1. Observation (structured)
The authors interest shall be to observe the planning, functional
organisation, zoning, and space utilization in the Hospitals under
investigation. This shall be done by recording observation in
writing, using annotated diagrams, sketches and through
photographic recording.
2. Interviews (non-structured)
Figure 3-2:5m measuring tape used for data
collection
Source:
3.
Physical measurements
The author shall use physical measurements to determine certain
measurable aspects such as corridor sizes, inter-departmental
distances and ward sizes. This shall be done using 5M and 50 M
measuring tapes.
3.6.
2. Background information
Background Information such as the establishment, catchment
population, bed capacity and bed occupancy levels shall be
collected from the hospital administration. This shall help in
analysing and determining whether the facilities are
overstretched, underutilized or optimized.
a)
b)
c)
d)
e)
f) Black Pen.
4
0
Study parameter
Representation
Size of site
Zoning
Ease of evacuation
Separation of traffic
Analy
Availability
sis of land
4
1
floor plans
Scale
sections ,Images
Access
Communication spaces
Circulation spaces
Sensitivity to semi-ambulant
needs
Services
Landscaping
Ventilation/air flow
Lighting
Places of rest
Neighbourhood
Catchment population
Materials
4
4
CHAPTER
FOUR:
ANALYSIS
4.0. Introduction
DATA
PRESENTATION
AND
4.1.2
Current status
Figure 4-3: A monument of the nursing tower at KNH Source: Author (14 th August 2014)
4.1.3
Hospital Services
Figure 4-4: An Image of Kenyatta National Hospital taken from Ngong road Source: Author (14 th August 2014)
OLD HOSPITAL
HOSPITAL
MAIN
KITCHE
N
NURSING TOWER
MORTUARY
SERVICE
ROAD
ADMI
N
BLOC
K
DELIVERY
SUITE
HELIPAD
A& E
OUTPATIE
NT
CLINICS
LANDSCAP
ED
GARDEN
ENTRANCE -A
OUTPATIE
NT
PARKING
Figure 4-5: An image of the model of Kenyatta
th
National Hospital Source: Author (15 August
2014)
BUS
STOP
MAIN
PARKING
ENTRANCEB TO A& E
ONLY
47
4.1.4
4
9
4.1.5
Zoning
4.1.5.1
Clinical zone
5
0
4.1.5.2
Nursing zone
4.1.5.3
Support zone
The support zone satisfies all the physical and material needs of
the nursing and clinical zones. It comprises of:
Kitchen & dining
Oxygen plant
General stores
Boiler house
Drug stores
Incinerator
Figure 4-10: The support services block at KNH housing
theCentral Sterile and
Maintenance department
C.S.S.D, general stores, kitchen and dining Source: Author Supplies
laundry
Department(C.S.S.D)
Theatre Sterile
Supplies Unit(T.S.S.U)
The three zones have been intrinsically tied together to act as
one homogenous unit. Varying typologies have been used to
assemble the three basic hospital zones. The nursing zone has
adopted the vertical model and it is the most outstanding and
dominating element in the Kenyatta national hospital complex.
The clinical zone has adopted single storied horizontal planning
strategy except the Accident and emergency /casualty wing
which is double storied. However, the ground floor is used by
patients whereas the first floor is office space for the hospital
management. The support zone adopts the horizontal planning.
nd
Interestingly, the kitchen is located in the 2 floor of the
support zone and
rd
th
52
4.1.6 CIRCULATION
The external circulation has greatly influenced the functional
organisation of the interdepartmental relations at Kenyatta
National Hospital.
4.1.6.1
Access
Figure 4-14: Pedestrian walkways have been used to avoid vehicular and pedestrian conflict.
Source: Author
53
54
4.1.6.2
5
5
separating the traffic from the hospital and the academic zone
while the two still acting as one homogenous unit.
5
6
Hospital Street
4.1.6.3
Internal Circulation
4.1.6.4
4.1.6.5
Circulation spaces
4.1.6.6
Communication spaces
Figure 4-22: Internal circulation map at Kenyatta National hospital Source: Author
58
4.1.7
hospital Model:
Disadvant
ages
The central corridor is too long and monotonous. This
creates boredom and increases the intra-departmental
distances.
This typology requires a big piece of land to develop hence
Figure 4-24: Image of the circulation spine in the old hospital Source:
not Author
suitable in small and congested sites
59
Figure 4-25: The old hospital as it existed before construction of the main hospital block Source: Author
60
3.6 metres
wide central
spine
61
62
Figure 4-28: Typical ward plan of the old hospital before relocation of the wards in the Nursing tower block Source: Author
4.1.7.2
Phase 1
However the typology still has its own limitations e.g. In areas
where deep plans have been used, it becomes hard to achieve
natural lighting and ventilation. This necessitates the use of roof
lights which are only functional in single storied buildings unless
an atrium has been provided
63
64
in1972.
Figure 4-32: Layout of the phase development at Kenyatta National Hospital Source: Author
65
4.1.7.4
Phase III
Figure 4-33: Layout of the phase-III development at Kenyatta National hospital. Source: Author
66
4.1.8
A&E Wing
LEGE
ND
Figure 4-36: Ground floor plan of A&E department at KNH
Source: Author
68
LEGE
ND
69
Interstitial floor
4.1.9
70
71
Figure 4-: A detailed analysis of the typical wards in at Kenyatta National Hospital
Source: Author
72
73
Figure 4-44: Sketch of a fire resistant door along the 3000mm wide corridors in the wards.
Source: Author
74
Figure 4-45: Analysis of the architectural design emergency features in a typical floor of the nursing tower Source: Author
75
4) Exit/Escape routes-Each set of the double wards in the typical floor plan of the nursing tower has 2
accessible exits for horizontal evacuation/escape route and an internal emergency escape staircase
for vertical evacuation.
5) Exit signs-All doors along the corridors in the nursing tower and emergency staircases have visible
exit signs fixed on door frames. This enables an individual to identify the escape routes at all times
even when the door is open.
6) Ramps The Obstetrics wards in the first floor of the nursing tower have access to a ramp that .This
ramp creates ease of movement for the patients, from the wards to the delivery suite in the ground.
The ramp can be particularly helpful in evacuating semi-ambulant persons with ease and speed from
the first floor to the courtyard in the ground floor. However this ramp is only limited to the first floor.
Figure 4-46: The
ramp
serving
the obstetrics
wards
in the first
floor and
the lifts
delivery
suite
in the Ground floor
at KNH.
Source:
7) Wide
corridors
The main
circulation
corridor
at the
lobby
is approximately
6metres
wide.
The Author
interior circulation aisle in the wards is approximately 3 metres wide. The wide corridors can be
particularly helpful in emergency evacuation. Patients and visitors can be evacuated into the 6metres
wide corridor as they await transfer to safer areas.
Figure 4-47: Fire exit sign at an emergency escape door at KNH Source: Author
7
6
EXTENDED COURTYARD
MODEL
Deep plan
Narrow plan
LAYOUT
IMAGE
PLAN
TYPOLOGY
SIZE OF SITE
EASE OF
EVACUATION
FLEXIBILITY AND
GROWTH
SEPARATION OF
DISSIMILAR
TRAFFIC
PATIENT ADMISSION
TRAVEL/DEPARTMEN
TAL DISTANCES
SCALE
NATURAL
VENTILATION
NATURAL LIGHTING
Table 4-1: Comparative analysis of the horizontal models at Kenyatta National Hospital Source: Author
8
0
8
0
8
1
8
2
4.2.2
Renovated 1892
old hospital
South
extension
Outpatient
Department
4.2.3
The Nanjing Drum hospital tower won the 2013 healthcare WAN
award for its healing gardens. Interestingly, the English word
hospital originates from Latin, meaning Gathering Guests,
Figure 4-61: A detail of the gardenised envelope Source: (20 th Nov 2014)
Figure 4-62: The 6 healing Gardens at Nanjing Drum hospital Source: (20 th Nov
4.2.4
th
Figure
4-65:
site Author
plan of modified
Nanjing drum
hospital
Source:
(20 tower
Nov 2014)
Figure 4-66: Ground Floor plan of Nanjing drum tower hospital South Extension Source: Author modified (Nov 20 th 2014)
Figure 4-67: Diagrammatic arrangements of departments at the south extension at Nanjing drum tower hospital Source:
89
floor
plan
has utilized a deep plan with double banked
Figure 4-69: First floor plan of the South extension at NanjingThe
drum
tower
hospital
Source: Author modified (Nov 21st 2014)
spaces. The second floor houses the imaging suite, inpatient,
coffee bar, outpatient surgery, clinic surgery and lithiasis
centre
9
0
The second, third and fourth floors are clinical zones. The floors
Figure 4-70: Typical 2nd, 3rd & 4th floor plan of the south
have a deep
plan
with double banked spaces which makes it
extension at Nanjing Drum Tower hospital Source: Author modified
(Nov 21
st 2014)
challenging to achieve maximum natural lighting and ventilation.
This has resulted in extensive use of air conditioners in the
hospital.
Figure 4-71: 5th floor plan of Nanjing Drum Tower hospital Source: Author modified (Nov 21 st 2014)
th
4.2.4.1 Zoning
93
Figure 4-74: Zoning plan of the typical 6th-13th nursing floors of the Nanjing Drum Tower Hospital Source: Author modified (27 th Nov 2014)
4.2.4.2 Circulation
th
th
11
Source: Author modified (27 Nov 2014)
th
94
Figure 4-76: Circulation flow plan in a typical nursing floor at Nanjing Drum Tower hospital Source: Author modified (27 th Nov 2014)
95
4.2.4.3
Emergency design features at Nanjing Drum
tower hospital.
Nanjing Drum tower Hospital has incorporated architectural
emergency design features for safe evacuation of patients in
case of disasters like fire. These include:
1) Emergency staircases The 14 storied building
with 3 basement floors has a set of 4
emergency staircases to aid in evacuation of
ambulant people. The emergency stairs are
approximately 1800mm wide to aid in mattress
evacuation
2) Compartmentalization of wards- The typical
th
th
96
Kenyatta National
Hospital
(Kenya)
LAYOUT
IMAGE
SECTION
9
7
TYPICAL
WARD
PLAN
Narrow plan
Sufficient natural ventilation through
cross ventilation & stack effect-no air
conditioners.
TYPOLOGY
+
+
MODEL
SIZE OF SITE
FLEXIBILITY
AND
GROWTH
EASE OF
EVACUATI
ON
SEPARATION
OF
DISSIMILAR
TRAFFIC
CIRCULATIO
N
NATURAL
VENTILATI
ON
NATURAL
LIGHTING
Table 4-2: Comparative analysis of Kenyatta National Hospital & Nanjing Drum Tower Hospital Source: Author
Introduction
5.2
th
were linked
theJune
gods
to
Figure 5-2: horizontal hospital model established in 19th century Source:
Author,to
12th
2014
10
0
10
0
10
1
10
2
Site planning.
Circulation.
Departmental distances.
Provision for future growth and extension.
Energy conservation and sustainability.
Ease of evacuation in cases of emergency.
Natural ventilation.
Natural lighting.
The author established that the size and value of the site greatly
influences the typology to be adopted in the planning and design
of the hospital. Circulation was established to be a major
Figure 5-11: Radial tower on podium model
influence in the planning and design of hospitals since once the
Source: Author modified 17th June 2014
circulation systems are designed, they remain as fixed elements
from which the hospital can change or grow for expansion to
meet future needs. External circulation influences the functional
organisation of the interdepartmental relations whereas the
Figure 5-12: Articulated tower on podium model internal circulation influences the functional organisation of
Source: Author modified 17th June 2014
intradepartmental relations within a hospital.
5.3
Conclusions on fieldwork
5.4
Recommendations
5.5
10
9
References
1) AECOM (2012). Design Excellence for Mid-Sized Urban/
Inner Suburban Medical Centers. Digital Case Studies, 510.
2) Allen R. W. & Karolyi, I. (1976) Hospital planning
handbook. New York: Wiley-interscience.
3) American Institute of Hospitals Consultants (1969).
Functional planning of General hospitals. New York:
McGraw Hill.
4) ArchDaily (December 26, 2013). Nanjing Drum Tower
Hospital / Lemanarc SA. ArchDaily. Retrieved on 11 July
2014 http://www.archdaily.com/?p=461173
5) Cox, A., & Groves, P. (1990). Hospitals and health-care
facilities: A design and development guide. London:
Butterworth Architecture.
6) Department of Health, UK (2013). Health Building Note 0004: Circulation and Communication Spaces. Retrieved on
13 July 2014 from
http://www.nationalarchives.gov.uk/doc/open-governmentlicence/
7) Groat, L. N. & Wang, D. (2002). Architectural research
methods. Hoboken, New Jersey: Wiley.
8) Hudenberg, R. (1969). Planning the community hospital. New York:
McGraw Hill.
11
0