Hospital Planning, Design and Facility Management

Introduction and Context

Hospital planning is the disciplined process of translating population health needs, service objectives and available resources into a safe, functional and sustainable healthcare facility. It includes estimating demand, selecting a location, determining bed capacity and service mix, arranging departments, designing circulation systems, providing utilities and biomedical infrastructure, and establishing systems for operation, maintenance and regulatory compliance.

Hospital design is not merely an architectural exercise. A hospital is simultaneously a clinical workplace, a public building, a complex engineering system, an emergency-response asset and a major financial investment. Poor planning can produce overcrowding, long patient journeys, infection risks, inefficient staff movement, excessive operating costs and unsafe conditions. Good planning supports quality, access, patient dignity, workforce productivity and resilience.

Planning decisions should be based on a service plan rather than on an isolated desire to construct a building. The service plan identifies the population to be served, priority health problems, clinical programmes, referral relationships, staffing model, technology requirements and expected activity. Facility planning then converts this plan into space, infrastructure and operational relationships.

Learning Objectives

By the end of this chapter, the learner should be able to:

1. Explain the major stages and principles of hospital planning.
2. Estimate basic service capacity and describe appropriate bed-mix decisions.
3. Evaluate location, accessibility and site-selection factors.
4. Organise functional departments and departmental adjacencies.
5. Describe requirements for circulation, utilities, biomedical infrastructure and maintenance.
6. Apply principles of infection prevention, universal accessibility, sustainability and resilience.
7. Identify statutory, ethical and governance responsibilities in facility development.
8. Analyse a hospital-planning problem and recommend an implementable solution.

1. The Hospital as a Functional System

A hospital may be understood as an interconnected system comprising:

• Inputs: patients, staff, supplies, information, energy, water and finance.
• Processes: assessment, diagnosis, treatment, nursing, surgery, rehabilitation, cleaning, logistics and administration.
• Outputs: safe care, improved health, patient experience, information, teaching and research.
• Feedback: incident reports, patient complaints, infection surveillance, maintenance data, utilisation measures and financial results.

This systems view prevents planners from designing departments independently. For example, increasing operating theatres without increasing recovery capacity, sterile processing, nursing staff, blood storage and inpatient beds may create a new bottleneck rather than improve performance.

A hospital master plan normally contains:

1. Needs assessment: demographic, epidemiological and service-use analysis.
2. Strategic service plan: services to be provided, referral level and operating model.
3. Demand and capacity plan: projected workload, beds, rooms, equipment and staffing.
4. Site and location plan: access, land, environment, hazards and future expansion.
5. Functional and architectural brief: room schedule, adjacencies and workflow.
6. Engineering and infrastructure plan: power, water, ventilation, information systems and waste management.
7. Financial and implementation plan: capital cost, operating cost, phasing and procurement.
8. Commissioning plan: testing, staff training, licensing, trial operation and opening.

Planning should be iterative. Changes in population, technology, financing, regulation or clinical practice may require revision before construction is complete.

2. Demand, Capacity and Bed Planning

2.1 Estimating service demand

Demand may be estimated from population projections, current utilisation, epidemiological rates, referral patterns, waiting lists and policy targets. Planners should distinguish between:

• Need: the level of health service required by a population.
• Demand: services people seek or are expected to seek.
• Utilisation: services actually delivered.
• Capacity: the maximum or planned service output possible with available resources.

Historical utilisation alone can be misleading. Low use may reflect poor access, insufficient trust, high cost or inadequate referral systems rather than low need.

For inpatient planning, a basic relationship is:

where:

• B = required beds;
• A = expected annual admissions, in patients per year;
• L = average length of stay, in days per admission;
• D = days in the planning period, usually 365 days;
• O = target occupancy expressed as a decimal, such as 0.80.

The equation assumes that annual admissions and average length of stay are reasonably stable, that bed capacity is interchangeable within the category being analysed, and that occupancy is measured consistently. It is a planning approximation, not a substitute for simulation or operational analysis.

The underlying relationship is:

and

Unit consistency is essential: admissions per year multiplied by days per admission produces patient-days per year; dividing by days per year produces bed-equivalents.

Worked example. A medical service expects 10,950 admissions annually, with an average stay of 5 days. The target occupancy is 80%.

Patient-days = 10,950 × 5 = 54,750 patient-days.

Required beds = 54,750 ÷ (365 × 0.80) = 187.5 beds.

The service therefore requires approximately 188 beds before considering isolation rooms, seasonal peaks, staffing constraints, surge capacity and the fact that different bed types may not be interchangeable.

2.2 Bed occupancy and turnover

Bed occupancy indicates how intensively beds are used:

Available bed-days equal staffed and operational beds multiplied by the number of days in the period. A bed that exists physically but lacks staff, equipment or approval should not be counted as an available bed.

Bed turnover may be expressed as:

Turnover is useful for comparing activity, but high turnover is not automatically desirable. It may indicate efficient short-stay care or, alternatively, premature discharge and excessive readmission risk. Occupancy above an appropriate threshold can reduce flexibility for emergencies and increase delays, whereas very low occupancy may indicate excess capacity or an unsuitable service model.

2.3 Bed mix

Bed capacity should be divided according to clinical function, acuity and patient flow. A typical bed-mix assessment may include:

• medical and surgical beds;
• maternity and neonatal beds;
• paediatric beds;
• intensive care and high-dependency beds;
• psychiatric or behavioural-health beds;
• isolation rooms;
• day-care and short-stay spaces;
• rehabilitation and palliative-care beds;
• emergency observation spaces.

The correct mix depends on the hospital’s level of care and referral role. A tertiary referral hospital may require more critical-care, diagnostic and procedural capacity than a district hospital. Bed numbers should not be planned without considering theatre sessions, emergency arrivals, discharge processes, community services and transport access.

3. Location and Site Selection

Location affects access, cost, workforce recruitment, emergency response and long-term viability. A structured site appraisal should examine the following dimensions.

Population and access

The site should be reasonably accessible to the intended catchment population. Analysis should include travel time, public transport, road quality, ambulance routes, pedestrian access and seasonal variation. Distance alone is insufficient: a site 10 kilometres away may be more accessible than one 5 kilometres away if roads and transport links are better.

Environmental and hazard conditions

The site should be assessed for flooding, seismic risk, landslides, extreme heat, storms, industrial pollution, noise, contaminated land and nearby hazards. Climate-risk assessment should consider both current exposure and projected future conditions.

Infrastructure and utilities

Availability and reliability of electricity, water, telecommunications, sewerage, drainage, waste services and emergency access are fundamental. A low-cost site with unreliable utilities may be more expensive over its life cycle than a better-served site.

Land, legal and economic factors

Ownership, zoning, title, easements, acquisition cost, taxes, construction logistics, expansion potential and neighbouring development must be reviewed. The site should allow service yards, parking, fire access, utility plant and future expansion without compromising patient areas.

Community and ethical considerations

Planning should consider environmental justice and the distribution of benefits and burdens. Communities should have meaningful opportunities to participate, especially where relocation, traffic, noise or environmental effects are likely.

A multi-criteria decision matrix can support transparent comparison. Criteria are assigned weights that sum to 1, each site receives a score, and the weighted scores are added:

This method structures judgement but does not remove it. Scores should be justified, sensitivity-tested and reviewed for hidden bias. A site with a high numerical score may still be unacceptable if it fails a legal, environmental or safety requirement.

4. Functional Planning and Departmental Adjacencies

Functional planning arranges spaces according to patient journeys, staff workflows, supply routes, information flows and infection-control requirements. The purpose is to minimise unnecessary movement, avoid cross-traffic and place related functions close enough for efficient operation.

4.1 Major functional zones

A general hospital may be organised into the following zones:

• Public zone: entrance, reception, registration, outpatient waiting and public amenities.
• Clinical zone: consultation, diagnostics, treatment, operating and inpatient areas.
• Critical zone: emergency, operating theatres, intensive care and resuscitation.
• Logistics zone: receiving, stores, kitchen, laundry, waste holding and sterile services.
• Administrative and support zone: offices, education, staff facilities, engineering and security.

The exact arrangement depends on the hospital’s model. Emergency services require rapid ambulance access and close relationships with imaging, laboratory, operating theatres and intensive care. Operating theatres require controlled access and efficient connections to surgical wards, intensive care, recovery, sterile processing and relevant diagnostic services.

4.2 Adjacency planning

An adjacency matrix may classify relationships as:

• Essential: direct proximity is required for safety or workflow.
• Desirable: proximity improves efficiency but is not indispensable.
• Acceptable: ordinary connection is sufficient.
• Undesirable: proximity may create infection, noise, privacy or security problems.
• Prohibited: the functions should not share direct access or uncontrolled movement.

Examples include:

Adjacency is not simply a matter of shortest distance. The route must also be safe, accessible, secure and appropriate to the type of movement.

4.3 Circulation and separation

Hospitals commonly require distinct or controlled routes for:

1. ambulatory patients and visitors;
2. emergency patients;
3. staff;
4. clean supplies and sterile materials;
5. used equipment and soiled materials;
6. food and catering;
7. waste and mortuary transport.

Complete physical separation is not always possible, particularly in smaller facilities. Where routes intersect, scheduling, access control, cleaning procedures, lift zoning and infection-prevention protocols can reduce risk.

Wayfinding should use clear signs, consistent symbols, legible language, colour used as a supplement rather than the sole identifier, adequate lighting and logical sightlines. Registration, waiting and toilets should be easy to locate. Privacy requires careful control of views, sound transmission and patient movement.

5. Accessibility, Safety and Human-Centred Design

Universal design aims to make facilities usable by the widest possible range of people without requiring special adaptation. Key elements include step-free routes, suitable ramps and lifts, accessible toilets, handrails, tactile and visual information, hearing assistance where required, adequate turning space, safe flooring and seating for people with limited endurance.

Accessibility includes cognitive and sensory needs. Signs should be understandable, lighting should avoid glare, and waiting environments should support people with dementia, autism or communication difficulties. Staff should not treat accessibility as an optional feature or as a separate pathway that stigmatises users.

Safety planning covers fire detection and suppression, evacuation, smoke control, emergency lighting, security, violence prevention, falls prevention, safe medical-gas systems, electrical protection and infection prevention. National building, fire, occupational-health and healthcare regulations must be treated as minimum requirements; risk assessment may justify higher standards.

6. Utilities and Biomedical Infrastructure

6.1 Electrical systems

A hospital requires normal power, emergency power and critical-power distribution. Essential loads may include life-support equipment, operating rooms, intensive care, emergency lighting, fire systems, communications, refrigeration and selected information systems. Design should address generator capacity, automatic transfer, fuel storage, uninterruptible power supplies, earthing, surge protection, testing and maintenance.

The design load should not be based only on the sum of equipment nameplates. Diversity, starting currents, future expansion and criticality must be assessed by qualified engineers. Electrical systems require documented single-line diagrams, labelling and safe isolation procedures.

6.2 Water, sanitation and drainage

Reliable potable water is necessary for drinking, cleaning, sterilisation, clinical care and sanitation. Planning should include storage, pressure, water-quality monitoring, hot-water safety, backflow prevention, emergency supply and protection against contamination. Drainage must control flooding, odour, cross-contamination and inappropriate discharge of chemicals or pharmaceuticals.

6.3 Heating, ventilation and air conditioning

Ventilation supports thermal comfort, contaminant control, infection prevention and equipment performance. Requirements vary by space. Operating rooms, isolation rooms, laboratories and sterile areas may require controlled pressure relationships, filtration, temperature, humidity and air-change performance. These parameters must be designed and verified against applicable national standards and clinical risk assessments rather than copied indiscriminately from another facility.

6.4 Medical gases and vacuum

Oxygen, medical air, nitrous oxide, carbon dioxide and vacuum systems require appropriate sources, storage, distribution, alarms, zone isolation valves, outlet identification, testing and maintenance. Medical-gas errors can be fatal; commissioning must verify gas identity, purity, pressure, flow, alarms and cross-connection protection.

6.5 Information and communication infrastructure

The digital hospital depends on reliable networks, clinical information systems, nurse-call systems, telephony, time synchronisation, cybersecurity controls and backup arrangements. Infrastructure should support interoperability, privacy and safe downtime procedures. Wireless coverage must be tested in clinical areas, lifts and emergency locations.

6.6 Biomedical equipment

Biomedical infrastructure includes diagnostic, therapeutic, monitoring, sterilisation and life-support equipment. The equipment plan should specify:

• clinical purpose and expected workload;
• technical specifications and compatibility;
• room size, shielding, ventilation and structural requirements;
• electrical, water, drainage and medical-gas connections;
• consumables and spare parts;
• user training and competency;
• calibration, preventive maintenance and decommissioning;
• cybersecurity for networked devices;
• lifecycle cost and replacement strategy.

Procurement should be based on total cost of ownership, not purchase price alone. A cheaper device may require expensive consumables, frequent repairs or unavailable technical support.

7. Facility Management and Maintenance

Facility management integrates buildings, engineering systems, equipment, people, safety, environment and service contracts to support the hospital’s mission. It begins before opening and continues throughout the asset life cycle.

7.1 Maintenance strategies

• Reactive maintenance: repair after failure. It may be appropriate for low-risk, non-critical assets but is unsafe as the primary strategy for life-support systems.
• Preventive maintenance: scheduled inspection, servicing or replacement based on time or use.
• Predictive or condition-based maintenance: intervention based on measured condition, trends or performance.
• Reliability-centred maintenance: selects maintenance tasks according to function, failure consequences and risk.

A risk-based approach prioritises assets whose failure could cause death, serious harm, service interruption, infection or major financial loss. An asset register should record location, unique identifier, manufacturer, model, commissioning date, risk category, maintenance history and responsible person.

Useful indicators include preventive-maintenance completion, equipment downtime, mean time to repair, repeat failures, utility consumption, water quality incidents and unresolved safety defects. Metrics should lead to corrective action rather than become targets disconnected from patient care.

7.2 Cleaning, waste and support services

Environmental cleaning is a clinical safety function. Policies should define frequencies, methods, chemicals, contact times, responsibilities, monitoring and response to contamination. Waste should be segregated at the point of generation, labelled, stored securely and treated or disposed of according to applicable law. Sharps, infectious waste, pharmaceuticals, chemicals and radioactive materials require specialised controls.

Laundry, food service, linen distribution, pest control, security and transport should be planned as operational systems with defined routes and service-level expectations.

8. Sustainability, Resilience and Life-Cycle Value

Sustainable hospital design reduces environmental harm while protecting clinical performance. Priorities may include passive shading, daylight without glare, efficient lighting, high-performance building envelopes, renewable energy where feasible, water conservation, rainwater management, low-emission materials, waste reduction and green procurement.

Energy-saving measures must not compromise ventilation, infection prevention, temperature control or patient safety. Life-cycle evaluation considers capital cost, operating cost, maintenance, replacement, disposal and environmental impact over the asset’s useful life.

Resilience means maintaining or rapidly restoring essential functions during disasters and disruptions. Planning should include backup power and water, redundant communications, protected plant rooms, flood barriers, alternate access routes, emergency stock, surge spaces, evacuation plans and business-continuity procedures. Climate adaptation should be integrated into site selection and engineering design rather than treated as an emergency add-on.

9. Statutory, Ethical and Governance Requirements

Requirements vary by jurisdiction, but hospital projects commonly require compliance with:

• land-use and building approvals;
• fire and life-safety codes;
• environmental and waste regulations;
• occupational health and safety law;
• accessibility requirements;
• radiation protection rules;
• medical-gas and electrical standards;
• water, food and sanitation regulations;
• licensing and accreditation requirements;
• procurement, contract and public-finance rules;
• privacy and cybersecurity obligations.

The project team should maintain a compliance register identifying each requirement, responsible owner, evidence of compliance, approval date and outstanding action. Compliance is not only a final inspection event; it must be embedded in briefing, design review, procurement, construction, commissioning and operation.

Ethical planning requires fairness, transparency and respect for dignity. Decisions about service distribution should consider vulnerable populations, rural access, disability, gender, language, poverty and cultural safety. Designers must avoid conflicts of interest, undisclosed vendor influence and specifications written to favour a particular supplier without defensible clinical or technical reasons.

10. Technology and Data-Supported Planning

Building information modelling can coordinate architecture, structure, medical gases, electrical systems and maintenance data before construction. Digital twins and sensor systems may support energy management, room utilisation, equipment tracking and predictive maintenance. Geographic information systems can analyse travel times, population distribution and emergency coverage.

Artificial intelligence may assist demand forecasting, space utilisation analysis or predictive maintenance, but it should not replace professional accountability. Data quality, representativeness, privacy, cybersecurity, explainability and bias must be assessed. A model trained on historical underuse may incorrectly conclude that a disadvantaged community needs fewer services. Clinical and community stakeholders must remain involved in decisions with safety or equity implications.

Illustrative Case: Reconfiguring a District Hospital

Background

A fictional district hospital serving approximately 250,000 people has 120 licensed beds. The emergency department is congested, elective surgery is frequently cancelled, and patients travel to a distant tertiary hospital for services that could be provided locally. The hospital occupies a constrained urban site with unreliable power and limited public transport access.

Problem analysis

Review of 18 months of data identified three principal problems: medical bed occupancy averaged 92%; the emergency department lacked observation capacity; and the operating suite was adjacent to a poorly controlled public corridor. Diagnostic imaging was distant from emergency and theatre areas. Equipment downtime was high because maintenance records were incomplete.

The hospital did not simply need more beds. High occupancy reflected delayed discharge, limited community rehabilitation and an inappropriate mix of inpatient and short-stay capacity. The project team also found that the electrical generator did not support all critical loads and that clean supplies crossed the route used for waste removal.

Approach and solution

The team established a planning group including clinicians, nurses, engineers, infection-prevention staff, patients, finance officers and local authorities. Demand analysis supported conversion of 12 general beds into a short-stay medical assessment unit, development of a six-bed high-dependency area, and creation of a discharge-coordination service linked to community providers. The licensed total was not increased initially.

The emergency department was reorganised around triage, resuscitation, assessment, observation and discharge zones. Imaging received a controlled connection to emergency. A secure clinical route was created between theatres, recovery and intensive care. Public and service entrances were separated, and waste movement was scheduled and physically controlled.

A critical-equipment register was created, with risk categories and preventive-maintenance schedules. The electrical project added automatic transfer capacity for critical loads and tested generator performance under realistic demand. Accessibility improvements included a step-free entrance, clearer wayfinding and accessible toilets.

Outcome

After implementation, the hospital reported shorter emergency stays, fewer elective cancellations and improved maintenance completion. The most important improvement came from coordinated discharge planning rather than construction alone. The project also demonstrated that infrastructure upgrades must be linked to staffing, policies, training and measurement.

Learning points

1. Capacity is a system property, not merely a bed count.
2. Functional adjacencies should follow patient and material flows.
3. Reliability of utilities is a clinical-safety issue.
4. Maintenance data should guide investment priorities.
5. Small operational redesigns can produce substantial benefits when supported by appropriate infrastructure.
6. Outcomes should be evaluated after opening and used to refine the master plan.

Challenges and Limitations

Hospital planning involves uncertainty. Population estimates may be wrong, clinical technologies may change, and funding may be released in stages. Excessive flexibility can increase cost, while rigid design can become obsolete. Benchmark ratios from another country or hospital may not transfer because staffing, epidemiology, climate, regulation and care pathways differ.

Forecasts should therefore include assumptions, sensitivity analysis and alternative scenarios. Construction budgets should distinguish capital cost from recurrent staffing, utilities, maintenance, consumables and replacement costs. Stakeholder consultation can be time-consuming, but excluding users often creates expensive redesign later.

A final limitation is the risk of treating standards as a substitute for judgement. Standards establish minimum or recommended conditions; competent professionals must still evaluate the specific patient population, hazards, workflows and operational capacity.

Best-Practice Checklist

Before approving a hospital facility plan, managers should be able to answer yes to the following questions:

• Is the service plan based on documented population need and referral relationships?
• Are capacity assumptions, bed mix and occupancy targets explicit?
• Has the site been assessed for access, hazards, utilities and expansion?
• Are essential departmental adjacencies and route separations documented?
• Are accessibility, privacy, infection prevention and security integrated?
• Have critical utilities and biomedical equipment been risk-assessed?
• Is there a funded maintenance and asset-management plan?
• Are sustainability and climate resilience addressed over the asset life cycle?
• Is statutory compliance assigned, documented and independently verified?
• Are commissioning, staff training, evaluation and post-occupancy review planned?

Chapter Summary

Hospital planning converts population needs and service strategies into safe, functional and sustainable facilities. Effective planning begins with a needs assessment and service plan, followed by demand forecasting, capacity analysis, site selection, functional zoning and detailed infrastructure design. Bed calculations based on admissions, length of stay, available days and target occupancy are useful approximations, but must be interpreted alongside acuity, staffing, discharge systems and surge requirements.

Location decisions should consider access, hazards, utilities, legal conditions, expansion and equity. Functional planning must organise departments according to patient, staff, supply, waste and information flows. Accessibility, infection prevention, privacy, fire safety and security are core design responsibilities. Electrical power, water, ventilation, medical gases, information systems and biomedical equipment require risk-based engineering and commissioning.

Facility management sustains performance through asset registers, preventive and condition-based maintenance, cleaning, waste control and monitoring. Sustainability and resilience extend beyond energy efficiency to include life-cycle value, climate adaptation and continuity of essential services. Statutory compliance, ethical governance, stakeholder participation and responsible use of digital technologies are necessary throughout the project life cycle. The central lesson is that a hospital is an integrated socio-technical system: buildings produce value only when aligned with people, processes, equipment and governance.

Key Terms

Hospital master plan: A coordinated long-term plan for services, site development, buildings, infrastructure and implementation.

Needs assessment: Systematic analysis of population health needs and service requirements.

Capacity: The service output that available staff, space, equipment and systems can provide.

Bed occupancy: The proportion of available bed-days used by inpatients.

Bed mix: Distribution of beds among medical, surgical, critical-care, maternity and other categories.

Average length of stay: Average number of inpatient days per admission.

Functional planning: Arrangement of spaces according to clinical, operational and support workflows.

Adjacency: The required degree of physical relationship between departments or functions.

Universal design: Design intended to be usable by people with diverse abilities without special adaptation.

Wayfinding: Signs, spatial cues and environmental features that help users navigate a facility.

Medical gases: Clinical gases and vacuum supplied through controlled hospital systems.

Biomedical equipment: Equipment used for diagnosis, monitoring, treatment or life support.

Asset register: Controlled record of equipment, infrastructure, location, risk and maintenance history.

Preventive maintenance: Planned servicing performed before failure occurs.

Condition-based maintenance: Maintenance triggered by measured asset condition or performance.

Life-cycle cost: Total capital, operating, maintenance, replacement and disposal cost over an asset’s life.

Resilience: Capacity to withstand, adapt to and recover from disruption.

Commissioning: Formal process of testing, verifying and accepting building systems before operation.

Post-occupancy evaluation: Systematic assessment of facility performance after users occupy it.

Compliance register: Record linking legal or technical requirements to responsible persons and evidence.

Review Questions

Short Answer Questions

1. What is the difference between need, demand, utilisation and capacity?
2. State the basic formula used to estimate required inpatient beds and define its variables.
3. Identify four factors that should be considered when selecting a hospital site.
4. Why is departmental adjacency important in hospital design?
5. Distinguish preventive maintenance from reactive maintenance.

Long Answer Questions

1. Explain the major stages of a hospital master-planning process.
2. Discuss how bed mix, occupancy, average length of stay and discharge systems influence capacity planning.
3. Describe the principles of functional zoning, circulation and separation of clean and dirty flows.
4. Explain the role of utilities and biomedical infrastructure in clinical safety.
5. Discuss how sustainability, resilience and life-cycle costing should influence hospital facility decisions.

Analytical / Application Questions

1. A proposed hospital expects 14,600 admissions per year, an average length of stay of 4 days and a target occupancy of 80%. Calculate the approximate number of beds required and state two limitations of the calculation.
2. Compare two potential hospital sites using access, hazards, utilities, legal status, expansion and equity as criteria. Recommend a transparent decision method and explain how you would test the robustness of the result.
3. An emergency department is overcrowded despite having adequate licensed beds. Develop a systems-based diagnosis covering patient flow, observation capacity, imaging access, discharge, staffing, utilities and maintenance, and propose an improvement plan.

Multiple Choice Questions with Answers

Question 1

Which expression estimates required inpatient beds when admissions, average length of stay and target occupancy are known?

A. Admissions × occupancy ÷ length of stay

B. Admissions × length of stay ÷ (days in period × occupancy)

C. Admissions ÷ (length of stay × days in period)

D. Length of stay × occupancy ÷ admissions

Correct Answer: B. Admissions × length of stay ÷ (days in period × occupancy)

Question 2

A hospital has 8,000 annual admissions, an average length of stay of 3 days and an occupancy target of 80%. Approximately how many beds are required?

A. 33 beds

B. 55 beds

C. 82 beds

D. 100 beds

Correct Answer: C. 82 beds

Question 3

Which factor is most directly associated with functional adjacency planning?

A. Colour of external landscaping

B. Relationship between patient, staff, supply and waste flows

C. Hospital advertising strategy

D. Number of hospital employees’ dependants

Correct Answer: B. Relationship between patient, staff, supply and waste flows

Question 4

Which maintenance strategy uses measured equipment condition or performance to decide when intervention is needed?

A. Reactive maintenance

B. Preventive maintenance

C. Condition-based maintenance

D. Deferred maintenance

Correct Answer: C. Condition-based maintenance

Question 5

Which location characteristic is a potential reason to reject an otherwise inexpensive hospital site?

A. Availability of natural daylight

B. Reliable public transport

C. Unacceptable flood risk

D. Potential for future expansion

Correct Answer: C. Unacceptable flood risk

Question 6

Why should a hospital maintain an asset register?

A. To replace all equipment annually

B. To record assets, risks, locations and maintenance history

C. To eliminate the need for staff training

D. To calculate patient satisfaction only

Correct Answer: B. To record assets, risks, locations and maintenance history

Question 7

Which route separation is generally desirable in hospital logistics?

A. Clean supplies and infectious waste using the same uncontrolled route

B. Public visitors and mortuary transport sharing an unrestricted route

C. Clean supplies and used materials managed through controlled, separated flows

D. Ambulances and pedestrian visitors using an identical entrance

Correct Answer: C. Clean supplies and used materials managed through controlled, separated flows

Question 8

What is a major limitation of using historical utilisation alone to forecast hospital demand?

A. It always overestimates demand

B. It may reflect barriers to access rather than true population need

C. It cannot be recorded electronically

D. It measures only building age

Correct Answer: B. It may reflect barriers to access rather than true population need

Question 9

Which activity is part of commissioning?

A. Testing and verifying building systems before operation

B. Selecting the hospital logo

C. Removing all preventive-maintenance schedules

D. Replacing the service plan with a marketing plan

Correct Answer: A. Testing and verifying building systems before operation

Question 10

Which statement best describes life-cycle costing?

A. It considers purchase price only

B. It considers capital, operating, maintenance, replacement and disposal costs

C. It excludes energy and staffing costs

D. It is used only for architectural decoration

Correct Answer: B. It considers capital, operating, maintenance, replacement and disposal costs