Inpatient Unit - General
Inpatient Unit - General
Contents
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Inpatient Unit - General
The prime function of the Inpatient Unit is to provide appropriate accommodation for the delivery of
health care services including diagnosis, care, and treatment to inpatients.
The Unit must also provide facilities and conditions to meet the needs of patients and visitors as well as
the workplace requirements of staff.
Description
The Inpatient Unit is for general medical and surgical patients. An inpatient is someone who spends more
than 24 hours in a health care facility.
This Functional Planning Unit (FPU) covers the requirements of a general Inpatient Accommodation unit.
This unit is sometimes referred to as a “Ward”, “Nursing Unit” , “Inpatient Department” (IPD) or
“Inpatient Unit” (IPU). Inpatient Unit is for the overnight care of patients.
A common definition of this Unit is accommodation for patients over 24 hours or more, which involves
overnight stary. However, nothing in the description or design of this unit prevents patients from staying
for less than 24 hours or being discharged without overnight stay.
The Inpatient Unit General is suitable for a wide variety of patients and treatment types including Medical
and Surgical patients. In larger health facilities this Unit may be further specialised for cardiology,
neurology, neurosurgery, oncology, orthopaedic surgery, gynaecology, and a variety of other specialties.
The unit’s fundamental provisions, however will remain the same. Patients awaiting placement elsewhere
may also be accommodated in this type of Unit.
The same provisions as Inpatient Unit General also apply to Inpatient Units for Paediatrics and
Rehabilitation. However, some additional provisions are necessary as outlined separately in this FPU.
More specialised units for Maternity and Bariatrics have separate FPU’s which are also included in these
Guidelines. The basic requirements of the more specialised units are the same as the Inpatient Unit
General but with additional facilities such as Nursery for Maternity and Gym for Rehabilitation.
Therefore, a thorough understanding of the Inpatient Unit General, its typical models of planning and the
Standard Components required will assist in the preparation of other specialised unit types, even if they are
not explicitly included in these Guidelines.
The typical “efficient” Inpatient unit is defined as 30 beds (± 2) with the minimum support spaces and
human resources required. Up to another half unit (eg 15 beds) may be directly attached to a full 30 bed (±
2) General Inpatient Unit to create a larger 45 bed unit (± 2) under the same unit management. For these
additional beds several supplementary support rooms should be provided as indicated in these guidelines.
There are several fundamental planning geometries which are used for the design of Inpatient Units (of all
types). These have been shown as Functional Relationship Diagrams, indicating the planning principles and
preferred relationship of the components. The concept of Swing Beds is defined as a flexible management
practice and shown in the diagrams for the planning models. Swing beds are a collection of rooms shared
between two adjoining Inpatient Units, allowing for the fluctuation of bed numbers. This is achieved by
increasing the number of beds in one unit and decreasing in the adjacent unit. The provision of the
additional 15 bed extension mentioned above can be used in conjunction with the Swing Bed design
strategy.
The typical unit Schedule of Accommodation is provided using Standard Components (typical room
templates) and quantities for a standard 30 bed unit as well as an optional 15 bed extension. The details of
this FPU follow overleaf.
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The physical environment should permit of a range of models of care to be implemented, allowing
flexibility for future changes and efficiency gains.
Levels of Care
The levels of care range from acute nursing and specialist care (high dependency), with a progression to
intermediate care, to non-acute care prior to discharge or transfer.
Patients requiring 24-hour medical intervention or cover are generally not nursed or managed within the
Inpatient Unit General. Such patients are typically referred to Intensive Care Unit (ICU) or a step-down
ICU referred to as High Dependency Care (HDU). For ICU and HDU, refer to the Intensive Care FPU
within these guidelines.
Bed Numbers and Supporting Components
Each Inpatient Unit may contain up to 30 patient beds (±2) and shall have Bedroom accommodation
complying with the Standard Components included in the Schedule of Accommodation (SOA) in this
FPU.
Additional beds up to 15, as a direct extension of a standard 30 bed (±2) are permitted with additional small
sized support facilities for example 1 extra Sub Clean Utility, Sub Dirty Utility and storage. The minimum
provisions for the 15-bed extension are provided as part of the Schedule of Accommodation (SOA) in this
FPU.
Any extension beyond 15 additional beds will be regarded as a separate unit requiring the full set of
support rooms as per the Schedule of Accommodation (SOA) in this FPU.
The preferred maximum number of beds in an Inpatient Unit customised as Maternity or Paediatric Units is
25 to 27 beds. This is due to the need for additional facilities such as indoor play areas (for Paediatrics) and
General Care Nursery (for Maternity).
A minimum of 50% of the total bed complement shall be provided as Single Bedrooms in an Inpatient
Unit used for overnight stay. However, it is recommended to increase the number of single bedrooms to a
minimum of 80% of total bed count as the current trend is to provide a greater proportion of single bed
rooms largely for infection control and privacy reasons.
If the provision of a large number of single bedrooms is not possible (for example due to costs), then the
best recommendation is to provide the shared bedrooms in a 2-bed configuration. This permits most of the
2-bed rooms to be used by a single patient until the occupancy level of the hospital demands urgently
require to use of the second bed in the room.
Larger shared rooms, up to 4 and 6 beds are available through the IHFG Standard Components and are
permitted with the consent of the local Health Authority but are not recommended by IHFG in the long
term.
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Swing Beds
For flexibility and added options for utilisation it may be desirable to include provisions for Swing Beds.
This may be a single bed or a group of beds that may be quickly converted from one category of use to
another. An example might be long-stay beds which may be temporarily used as acute beds at a time of
high occupancy. Other examples may include a group of shared beds located between two adjoining
Inpatient Units which may experience fluctuating utilisation rates.
At any given time, swing beds are part of an Inpatient Unit in terms of the total number of beds and the
supporting components of the units whilst taking advantage of the additional 15 bed extension when
required. Three typical permutations of Swing Beds are shown below:
Example 2 – Two full units and intermediate 15 bed swing bed unit
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Facility design for swing beds often enabled by adding wide doors within the connecting corridor. These
doors may be closed or held-open depending on the swing bed numbers required on one side or the other.
By closing one set of doors whilst opening all other doors, the swing bedrooms may be shifted from one
Unit to the adjoining Unit. This technique will also require provision for switching patient/ nurse call
operation from the Staff Station in one Unit to the other Unit. Security aspects of this arrangement should
also be considered, for example in situations where access control is preferred between the Units.
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Sample functional relationship diagrams of each of the above planning models are provided below.
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Bed Configurations
In the above diagrams, the number and type of the patient bedrooms are symbolic. In actual
design the recommended efficient bed number per unit is 30 (±2).
The bedroom types may be:
Single bedrooms
2-bed rooms
4-bed rooms
6-bed rooms
However, iHFG recommends only the use of single and 2-bed rooms for new facilities, when this is
possible and affordable.
The Ensuite (means attached) Bathrooms are also optional. These can be according to one of the following
permutations:
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Functional Areas
The Inpatient Accommodation Unit comprises the following Functional Areas or zones:
Entry/ Reception area (may be a shared area or provided at the Main Entry) with
- Reception desk, (optional)
- Visitors Lounge, can be shared between 2 Units
- Interview Room
- Gowning for Staff and Visitors (optional)
Patient Areas - areas where patients are accommodated, or facilities specifically serve patients
including:
- Bedrooms
- Ensuites
- Patient Lounge
- Patient Laundry for specialist Units
Support Areas that support the functions of the unit including:
- Beverage Bay or Pantry
- Bays for handwashing, linen, meal trolleys, resus trolley, mobile equipment etc.
- Cleaner’s room
- Clean and Dirty Utility rooms
- Stores for equipment and general stock
Staff Areas - areas accessed by staff, comprising:
- Staff Station and Office for Clinical Handover
- Offices for administration
Shared Areas - public and clinical areas that may be shared by two or more Inpatient Units
including:
- Bathroom
- Visitor Lounge
- Public Amentities
- Staff Amenities with Staff Room, Toilets and Locker areas
- Treatment Room, according to service demand
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Ensuites; an ensuite to be provided for each 1-bed or 2-bed rooms and to include a shower, WC and a
hand wash basin. For 4-bed and 6-bed rooms, there must be at least one WC and one shower per room.
If WC and shower are provided in two separate rooms, each must also include a hand wash basin. An
ensuite cannot be shared between two separate rooms.
Lounge areas: may be optional if all rooms in the Unit are single. In a Unit with beds in a shared
room, lounge areas should be provided.
On-ward gym: depending on the operational policy of the hospital, on-ward gyms may be provided
for immediate post-surgery rehabilitation in preference to transfer to (or in addition to) a central gym.
These rooms may also be configured as multi-purpose rooms and used for a variety of purposes
including ad-hoc meeting or patient education.
All Patient areas are to comply with Standard Components in these Guidelines.
Other Inpatient Units with specific clinical specialties are also available in these Guidelines. They include
Bariatric, Long-Term Care (LTC), Mental Health, Paediatric and Rehabilitation. These can be found in Part
B - Functional Planning Units.
Support Areas
Support Areas include:
Handwashing, Linen, and Equipment bays
Clean Utility, Dirty Utility and Disposal Rooms
Beverage Bays and Pantries
Meeting Room/s and Interview rooms for education sessions, interviews with staff, patients and
families and other meetings
Staff Areas
Staff Areas consist of:
Offices and workstations
Staff Room
Staff Station and clinical handover room
Toilets, Showers and Lockers
Offices and workstations are required for administrative as well as clinical functions to facilitate
educational/ research activities.
Staff Areas, particularly Staff Rooms, Toilets, Showers and Lockers may be shared with adjacent Units as
far as possible.
Shared Areas
In addition to the shared Staff areas above, Shared Areas include:
Patient Bathroom (assisted)
Treatment Room
Public Toilets
Visitor Lounge
Family Visiting Room (if culturally required)
Some of the Staff Areas
Shared Areas is possible between more than one Units if they are sized to meet the needs of the Units they
serve.
Functional Relationships
The Inpatient Unit is a key functional component of the hospital, connected with many clinical and
operational support units. Correct functional relationships promote delivery of services that are efficient in
terms of management, cost and human resources.
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External
Principal relationships with other Units include:
Ready access to diagnostic facilities such as Medical Imaging
Ready access from the Emergency Unit
Ready access to Critical Care Units (ICU and CCU)
Ready access to Clinical Laboratories and Pharmacy (possible use of Pneumatic Tube System)
Ready access to Material Management, Housekeeping and Catering Units
Inpatient Surgical Units require ready access to Operating/ Day Procedures Units.
Principal relationships with public areas include:
Easy access from the Main Entrance of a facility
Easy access to public amenities
Easy access to parking for visitors
Principal relationships with Staff Areas
Ready access to staff amenities which may be shared by multiple Units in a central location
Note: Inpatient Units must not be located so that access to one Unit is via another Unit with the Swing Bed
components being the only exception.
Internal
Optimum internal relationships include:
Patient occupied areas as the core of the unit
The Staff Station and associated areas need direct access and observation of Patient Area corridors
Utility and storage areas need ready access to both patient and staff work areas
Public Areas should be on the outer edge of the Unit
Shared Areas should be easily accessible from the Units served without passing through another
Unit
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3 Design Considerations
Refer to Part C for – Access, Mobility and OH&S, Part D for Infection Control, and Part E for
Engineering requirements.
Environmental Considerations
Acoustics
The Inpatient Unit should be designed to minimise the ambient noise level within the unit and
transmission of sound between patient areas, staff areas and public areas. Consideration should be given to
the location of noisy areas or activity, preferably placing them away from quiet areas including patient
bedrooms.
Acoustic treatment is required to the following:
Patient bedrooms
Interview and meeting rooms
Treatment rooms
Staff rooms
Toilets and showers
Natural Light
The use of natural light should be maximised throughout the Unit. Windows are an important aspect of
sensory orientation and psychological well-being of patients. All bedrooms must have a window providing
natural light. Natural light is desirable in Inpatient areas such as lounge rooms Windows should provide an
open and pleasant outlook, preferably to a landscape area is highly desirable.
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Bedrooms may be configured with windows surrounding an internal courtyard (open to the sky) where
natural light penetrates. It is also possible to have bedrooms facing an internal multi-storey atrium if it is
filled with natural light. In both arrangements, care must be taken to prevent privacy issues.
Privacy
The design of the Inpatient Unit needs to consider the contradictory requirement for staff visibility of
patients while maintaining patient privacy. Unit design and location of staff stations offer varying degrees
of visibility and privacy. The patient acuity including high dependency, elderly or intermediate care is a
major influence.
Each bed in both single bedroom and shared bedrooms must be provided with bed screens to ensure
privacy of the patients undergoing treatment. Bed screens can either surround the bed providing sufficient
clearances between the bed and the screens or they can be located closer to the entry door of the bedroom.
Refer to the Standard Components in these Guidelines for examples.
Other factors for consideration include:
Use of windows in internal walls and/or doors, provision of privacy blinds
Location of beds that may affect direct staff visibility
Location of sanitary facilities to provide privacy for patients while not preventing observation by
staff
Location of external/ internal courtyards or atrium facing bedroom windows to prevent others from
looking into the bedrooms
Space Standards and Components
Room Capacity and Dimensions
Maximum room capacity is six patients in a room. It is recommended that all patient rooms should be
single or with 2 beds in new facilities. Although 4-bed rooms and 6-bed rooms are permitted but they are
not recommended and should be avoided.
Minimum dimensions, excluding such items as ensuites, built-in robes, alcoves, entrance lobbies and floor
mounted mechanical equipment shall be as follows:
ROOM TYPE WIDTH LENGTH
Single Bedroom 4200 mm 3600 mm
Two Bedroom 4200 mm 6400 mm
Four Bedroom 8400 mm 6400 mm
Six Bedroom 8400 mm 8950 mm
Depending on the operational policy, patient bedrooms may be equipped with comfortable
furniture for one or two family members/ carers without interfering staff member access to
patients.
Minimum room dimensions are based on overall bed dimensions (buffer to buffer) of 2250 mm long x
1050 mm wide. Minor encroachments including columns and hand basins that do not interfere with
functions may be ignored when determining space requirements.
Bed Spacing/ Clearances
Bed dimensions become a critical consideration in ascertaining final room sizes. The dimensions noted in
these Guidelines are intended as minimums and do not prohibit the use of larger rooms where required.
The design and arrangement of all patient beds, in relation to fittings, furniture, mechanical and electrical
services, and staff call systems, must comply with the standard components as well as the clearances that
they imply.
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Refer to the diagrams below for required clearances. These are intended to indicate the clearance around
beds and are not design suggestions of the room.
Typical Single Bedrooms
In single bedrooms there shall be a minimum clearance of 900mm (1200mm recommended) to both sides of
the bed and a clearance of 1200 mm available at the foot of the bed to allow for easy movement of
equipment and beds.
The clearance required around a bed in a single room is represented diagrammatically below:
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Typical 2 Bedrooms
In 2-bed rooms, the minimum distance between beds shall be 900 mm to each side of each bed and
1200mm at the foot of each bed and between the side of a bed and a wall; the distance between bed
centrelines must not be less than 2900 mm.
Paediatric bedrooms that contain cots may have reduced bed centres, but consideration must be given to the
spatial needs of visiting relatives. To allow for more flexible use of the room the above clearances are still
recommended. Consider allowing additional floor area within the room for the children to play.
The clearance required around beds is represented diagrammatically below:
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Fixtures and Equipment; includes all the serviced equipment commonly located in the room along
with the services required such as power, data, water supply and drainage; Fixtures and Equipment
are also identified with a group number as above indicating who is responsible for provision
Building Services - indicates the requirement for communications, power, HVAC (Heating,
Ventilation and Air Conditioning), medical gases, nurse/ emergency call and lighting along with
quantities and types where appropriate. Provision of all services items listed is mandatory.
The Room Layout Sheets (RLS’s) are indicative plan layouts and elevations illustrating an example of a
good design. The RLS indicated are deemed to satisfy these Guidelines. Alternative layouts and innovative
planning shall be deemed to comply with these Guidelines provided by the following criteria are met:
Compliance with the text of these Guidelines
Minimum floor areas as shown in the schedule of accommodation
Clearances and accessibility around various objects shown or implied
Inclusion of all mandatory items identified in the RDS.
Standard Components have considered the required design parameters described in these Guidelines. Each
FPU should be designed with compliance to Standard Components - Room Data Sheets and Room Layout
Sheets, nominated in the Schedules of Accommodation in Appendices of this FPU.
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6 Schedule of Accommodation
The Schedule of Accommodation (SOA) provided in the Appendices of this FPU represents generic
requirements for this Unit. It identifies the rooms required along with the room quantities and the
recommended room areas. The sum of the room areas is shown as the Sub Total as the Net Area. The total
area comprises of the sub-total areas of these rooms plus an additional percentage of the sub-total applied
as the circulation (corridors within the Unit). Circulation is represented as a percentage is the minimum
recommended target area. Any external areas and optional rooms/ spaces are not included in the total areas
in the SOA.
Within the SOA, room sizes indicated for typical units and are organised into functional zones. Not all rooms
identified are mandatory, therefore, some rooms are found as optional in the corresponding Remarks. These
Guidelines do not dictate the size of the facilities and the SOA provided represents a limited sample based on
assumed unit sizes. The actual size of the facilities is determined by the Service Planning or Feasibility
Studies. Quantities of rooms need to be proportionally adjusted to suit the desired unit size and service needs.
The Schedule of Accommodation are developed for particular levels of services knowns as Role
Delineation Level (RDL) and numbered from 1 to 6. Applicable RDL’s are noted in each SOA provided in
the appendices and not necessarily all six RDL’s are applicable. Refer to Part A for a full description of
the RDL’s.
The following should be considered in conjunction with the SOA/s provided in the Appendices of this
FPU:
Areas noted in Schedules of Accommodation take precedence over all other areas noted in this FPU
Rooms indicated in the schedule reflect the typical arrangement according to the Role
Delineation and/ or capacity required for the clinical service
Exact requirements for room quantities and sizes reflect Key Planning Units (KPU) identified in the
Service Plan and the Operational Policies of the Unit
All areas shown in the SOA follow the No-Gap system described elsewhere in these
Guidelines. Refer to Part B Preliminaries
Room sizes indicated should be viewed as a minimum requirement; variations are acceptable to reflect
the needs of individual Unit
Staff and support rooms may be shared between Functional Planning Units dependent on location and
accessibility to each unit and may provide scope to reduce duplication of facilities
Offices to be provided according to the number of approved full-time positions within the Unit Refer
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Bay – PPE bppe‐i 4 x 1.5 1 x 1.5 In addition to bays for isolation rooms.
Refer to Part D
Bay ‐ Linen blin‐i 2 x 2 1 x 2 Quantity and location to be
determined for each facility
Bay ‐ Meal Trolley bmeq‐4‐i similar 1 x 4 Optional; dependent on catering and
operational policies
Bay ‐ Mobile Equipment bmeq‐4‐i or bmeqe‐i 1 x 4 1 x 4 Quantity, size dependent on
equipment to be stored; can be
opened or enclosed
Bay ‐ Resuscitation Trolley bres‐i 1 x 1.5 1 x 1.5
Bay ‐ Pneumatic Tube NS 1 x 1 1 x 1 Optional, Locate at Staff Station or
under staff supervision
Clean Utility clur‐12‐i 1 x 12 1 x 12 May be Interconnected with
Medication Room
Medication Room medr‐i 1 x 10 1 x 10 May be Interconnected with Clean
Utility
Clean Utility / Medication clum‐14‐i 1 x 14 1 x 14 Optional; if combining Clean Utility and
Medication Room is preferred
Dirty Utility dtur‐12‐i dtur‐14‐i 1 x 14 1 x 12 2 may be required to minimise travel
distances
Disposal Room disp‐8‐i 1 x 8 1 x 8
Pantry ptry‐i 1 x 8 Optional; if Beverage Bay is required
Store ‐ Equipment steq‐10‐i steq‐16‐i similar 1 x 20 1 x 10 Size dependent on equipment to be
stored; staff access. Note: combining
all stores into one room is optional;
however if they are combined, they
must be separated into zones
Store ‐ General stgn‐8‐i similar 1 x 10 1 x 6 Size as per service demand and
operational policies
Cleaner’s Room clrm‐6‐i 1 x 6 Separate storage for dry goods, small
units may share
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Staff Areas
Staff Station sscu‐i sstn‐14‐i 1 x 14 1 x 9 May include ward clerk. Size and
location dependent on operational
policies
Office ‐ Clinical / Handover off‐cln‐i 1 x 15 1 x 15
Office ‐ Single Person off‐s12‐i 1 x 12 2 x 12 NUM office and clinical personnel as
needed
Meeting Room – Medium / meet‐l‐15‐i 1 x 20 Tutorial; shared between 2 units. Could
Large be used for counselling sessions
On‐Call Room ovbr‐10‐i 1 x 10 Required at the rate of 1 per 2 Units
maximum but does not necessarily
need to be located within the Units
however, must have convenient
access.
On‐Call Room ‐ Ensuite oves‐4‐i 1 x 4 Ensuite attached to On‐Call Room
above.
Staff Room srm‐15‐i similar 1 x 18 1 x 15 Include Beverage Bay
Property Bay – Staff prop‐3‐i 2 x 3 2 x 3 Separated for male and female.
Number of lockers depends on staff
complement per shift
Toilet – Staff wcst‐i 2 x 3 2 x 3 Separated for male and female
Sub Total 995.5 547
Circulation % 35 35
Total Areas 1343.925 738.45
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Standard
RDL 2 RDL 3 RDL 4 RDL 5/6
ROOM/ SPACE Component Remarks
Room Codes Qty x m2 Qty x m2 Qty x m2 Qty x m2
Rehabilitation
Consult/ Exam Room cons‐i 2 x 14
Gymnasium/ Multi‐purpose Size to suit the service; with a
gyah‐45‐i similar 2 x 40
room Control room as required
Based on 2m2 per patient, 25
Dining/ Activities dinr‐i similar 2 x 50
patients
Pantry/ Servery/ ADL Kitchen adlk‐enc‐i 2 x 12
ADL Bathroom adlb‐i 1 x 12
ADL Bedroom adlbr‐i 1 x 18
Toilet ‐ Patient, (Male/ Female) wcpt‐i 2 x 4
Sub Total 270
Circulation % 35
Total Areas 364.5
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Standard
RDL 2 RDL 3 RDL 4 RDL 5/6
ROOM/ SPACE Component Remarks
Room Codes Qty x m2 Qty x m2 Qty x m2 Qty x m2
1 Bed
1 Bed Room – Super Provide according to
1 br‐svip‐53‐i 1 x 53
VIP service demand
Provide according to
Ensuite – Super VIP ens‐svip‐i 1 x 20
service demand
Provide according to
Store – Equipment steq‐10‐i 1 x 10
service demand
Provide according to
Pantry – Super VIP ptry‐svip‐i 1 x 11
service demand
Lounge / Dining – Provide according to
ld‐svip‐i 1 x 26
Super VIP service demand
Family / Carer Provide according to
f‐cr‐svip‐i 1 x 34
Room service demand
Provide according to
Ensuite – Visitor ens‐vis‐i 1 x 5
service demand
Sub Total 159
Circulation % 35
Total Areas 214.65
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8 Appendix I Inpatient Unit - General, 30 Bed Unit, All Single Beds (RDL 3 to 6)
The SOA overleaf is for a 30 Bed Unit at RDL levels 3 to 6 with all single bedrooms. Although
categorised by level of service, this does not necessarily lead to different physical requirements. The
Schedule of Accommodation lists generic spaces that form an Inpatient Unit. Quantities and sizes of some
spaces need to be determined in response to the service needs of each unit on a case by case basis.
Lounge areas are only required when facility has shared bed rooms and service to provide family members
a waiting area if patients are not ready to receive them. If the facility has only single bed rooms, then lounge
areas inside units are not required at all; and an outside waiting area is optional.
Refer to SOA overleaf.
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9 Appendix II Inpatient Unit - General, 30 Bed Unit, Single and Shared Beds (RDL 3 to 6)
Similar to Appendix I, the SOA overleaf is for a 30 Bed Unit at RDL levels 3 to 6 but with a mix of single
bed rooms and 2 bed rooms. A minimum of 60% single bed rooms is recommended and reflected in this
SOA.
All support facilities and amenities required in this Unit are identical to those provided in Appendix I
where accommodation is only provided in single rooms.
Refer to SOA overleaf.
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