MAPUA INSTITUTE OF TECHNOLOGY

School of Architecture, Industrial Design, and Built Environment

PROPOSED REDEVELOPMENT OF OSPITAL NG TAGAYTAY:

CREATING THERAPEUTIC ENVIRONMENTS THROUGH
INNOVATIVE HOSPITAL DESIGN
___________________________________________

In Partial Fulfillment
Of the Requirements for the
Bachelor of Science in Architecture

______________________________
Presented by:

JAN ALLEN S.J. GOMEZ

Arch. Junar Pakingan Tablan

Adviser

CHAPTER I
THE PROBLEM AND ITS BACKGROUND
I.1.1 Introduction
Health is a fundamental right guaranteed by our constitution to all citizens. Health
care, on the other hand, depends on what each citizen can pay. Health inequity is very
evident in our society. The standard in health care for the rich in our country is far
different from that for the poor, and this disparity is growing. The quality of public health
is a major policy issue in every country, whether developed or developing. The
international community, both public and private, also assigns high priority to improving
health conditions in developing countries.
Health facilities are important components of the health care system. The
national government has been aiming for the provision of essential health services that
are accessible, affordable and equitable. Despite the progress cited by the national
government, the countrys public healthcare system is marred with problems. The lack
of health personnel, the absence of adequate facilities, and the remaining barriers for
the poor to access health care are just some of these problems.
Hospitals play a very big role in societys economic and social well-being. Their
healing and rehabilitative functions empower them to bring back a persons productivity
in society. It is very important that the hospital carry out its mission of healing
successfully. Hospitals are designed to not only support and aid safety of patients,
advanced medicine and technology, and quality patient care, but also envelope the
patient, family, and caregivers in a psycho-socially supportive therapeutic environment.
The characteristic of the physical environment in which a patient receives care affects
patient outcomes, patient satisfaction, patient safety, staff efficiency, staff satisfaction,
and organizational outcomes. The effects can be positive or negative. No environment
is neutral.
Facility designers and health care providers are recognizing the effect of the
physical environment on patient outcomes. Some studies have shown that a facilitys
design can influence the rate of nosocomial infections, errors in patient care, and the
cost associated with treating a given condition. Architects and interior designers who
work with hospitals are becoming increasingly aware of this growing body of evidence
and are taking it into account in their work.

I.1.2 Statement of the Problem:

The governments health agenda is to provide universal quality health care
to the public. The purpose of this research is to provide a new health facility that can
cater to upgraded services of the hospital with reference to the Department of Health
(DOH) initiatives on regulation and classification of hospitals and other health facilities in
the Philippines. The study aims to create innovations in the design of the new Ospital ng
Tagaytay by incorporating therapeutic designs.

I.1.3 Project Goal:

Design and plan the facilities of the Ospital ng Tagaytay that will meet the
new requirements of the Department of Health classification of hospitals in
terms of services offered and capacity to handle patients

The research aims to explore new solutions in designing and planning

architectural spaces with the therapeutic effects to the patients.

I.1.4 Objectives:

Determine the present and future needs and capacity of the hospital with
regards to the population of the city

Design and plan the hospital that meets the DOH classification by
incorporating spaces to the services added by the hospital to meet the
requirements.

Planning the hospital on the premise of new circulation due to the therapeutic
based design of the facilities.

I.1.5 Significance of the Study

One of the functions of this research is to provide creative and technical
assistance to public hospitals particularly to the Ospital ng Tagaytay. Determining the
current status of the general hospital can help identify the facilities needed to increase

the service capability and improve the quality of health care of the hospital. The results
of this study can be beneficial in providing recommendations for the redevelopment of
the hospital as a primary health care provider in the city of Tagaytay. It will also serve as
basis for future designs of public hospitals for innovative therapeutic designs.

I.1.6 Scope and limitation

The scope of the research shall be with the bounds of the design of the hospital
and integrating therapeutic environments in the planning and designing of the facilities.
The scope of the study shall also explore new architectural designs, planning of spaces
and study of behavioral circulation of the users in the hospital.
The assessment of the study was limited to 5 years of secondary data. The
limitations of this research are the available applicable designs and technology available
to aid in the healing process. The research is limited to architectural solutions of
integrating therapeutic environments in the design of the hospital. It aims to create and
enhance the design of spaces for therapeutic environments and not meddle with
management and procedural processes in the hospital.

I.1.7 Assumptions
The assumption of this research would be the development of public hospitals
complying with the new Department of Health classification requirements and would
integrate designs for therapeutic environments.

I.1.8 Conceptual Framework

PROPOSED REDEVELOPMENT OF
OSPITAL NG TAGAYTAY: CREATING
THERAPEUTIC ENVIRONMENTS
THROUGH INNOVATIVE HOSPITAL
DESIGN

PROBLEM ANALYSIS

METHODOLOGIES

RESEARCH &

CONDUCTING
SURVEYS

CASE STUDIES

FORMULATION OF ARCHITECTURAL
SOLUTION

CONCLUSION

GATHERING DESIGN
GUIDE LINES AND
RESTRICTIONS

I.1.9 Definition of terms

Accesible - is the degree to which a product, device, service, or

environment is

available to as many people as possible.

Healing- is the process of the restoration of health to an unbalanced, diseased or

damaged organism.

Health services- include all services dealing with the diagnosis and treatment of
disease, or the promotion, maintenance and restoration of health.

Hospitals- is a health care institution providing patient treatment with specialized

staff and equipment.

Incorporate - to include (something) as part of something else

Innovation - the act or process of introducing new ideas, devices, or methods

Integration - an act or instance of combining into an integral whole.

Patient- is any recipient of health care services.

Psycho-social- means it relates to one's psychological development in, and

interaction with, a social environment.

Rehabilitative- helping to restore to good condition; "reconstructive surgery";

"rehabilitative exercises"

Therapeutic- of or relating to the treatment of disease or disorders by remedial

agents or methods

Quality- the non-inferiority or superiority of something; it is also defined as

fitness for purpose.

CHAPTER 2
I.2.1 REVIEW OF RELATED LITERATURE AND STUDIES
I.2.1.1 DOH gives hospitals 3 more years to comply with reclassification
The Department of Health and representatives from private hospitals have
reached a compromise that will give healthcare facilities a maximum of 3 years to
comply with the government's hospital reclassification scheme MANILA, Philippines The Department of Health (DOH) and representatives from private hospitals have
reached a compromise that will give healthcare facilities a maximum of 3 years to
comply with the government's hospital reclassification scheme.
In a press briefing, Health Secretary Enrique T Ona told reporters the agreement
allows hospitals to beef up their facilities and comply with the DOH's new rules on
hospital classification based on Administrative Order No. 2012-0012."The AO will apply
immediately to new hospitals. For those that are already existing, especially those
without operating rooms, they will be given a maximum of 3 years, but I'm sure most of
them will be able to do it in a year or a year and a half," Ona said. Ona said half of the
estimated Level 1 hospitals under the old ruling need to spend some P10 to P15 million
to put up a decent operating room. This would put them under Level 1 category in the
new classification.
He said that as of 2011, there are a total of 733 government hospitals and 1,088
private hospitals. Presently classified as Level 1 are 771 facilities composed of 372
public hospitals and 399 private hospitals.
The health secretary said he's confident that after 3 years or earlier, more than
half of these Level 1 hospitals would be able to retain their classifications under the new
rules.
Private Hospitals Association of the Philippines (PHAP) President Rustico
Jimenez said they support the DOH's move. However, he said the DOH must help in
fast-tracking PhilHealth payments, which are often delayed, and reaching out to other
agencies on matters that currently hound hospitals.

Jimenez said one of these agencies is the Department on Environment and

Natural Resources. It has imposed a fine of P200,000 per day for improper hospital
waste management, which, Jimenez said, is difficult for some hospitals that don't own a
waste facility.
"As I said, we are agreeable to those terms because before, our request to
Secretary Ona was that only new hospitals [ought to] be covered by the AO. If you read
the AO, there was no mention of 3 years. After that, Secretary Ona released the 3 years
so I think we are agreeable to that," Jimenez said.
He also expressed the hope that DOH help the PHAP and the Philippine Hospital
Association (PHA) stay as members of the board of PhilHealth. Some lawmakers are
pushing for the removal of the two organizations from the board of PhilHealth on
grounds that their membership creates a conflict-of-interest situation.
New classifications under the new DOH reclassification order:
Level 1 hospitals should have the following facilities:
surgery room
isolation
surgical and maternity facilities
dental clinics
secondary clinical laboratory
blood station
first level X-ray
a pharmacy
Level 2 hospitals require additional departmentalized clinical services including:
a respiratory unit

high pregnancy risk unit

second level X-ray with mobile unit
Level 3 hospitals should have:
DOH-accredited teaching and training on 4 major clinical services, ambulatory
surgical and dialysis clinics and a blood bank

I.2.1.2 The Healing Environment: A Therapeutic Landscape

There remains so much more to consider in bringing the outdoors inside,
specifically for acute care and other hospital settings.Potted plants became a greater
part of modern life indoors when it was easier to transport them greater distances, and
this also allowed the enjoyment to cross class lines. Passive and active engagement
with

nature

outdoors

can,

for

example,

increase

positive

affect,

reduce

psychophysiological arousal, and renew an ability to perform tasks that require

concentration. This positive affect has transferred itself indoors to the degree that the
access is appropriate and to the extent that the individual is in need of restoration or
stress reduction (Bringslimark, Hartig, & Patil, 2009).
In the late 1960s, when John Portman designed the first Hyatt Regency in
Atlanta, hotels could no longer just landscape their porches and walkways. The
outdoors has been invited indoors almost five decades, with inside offices having
windows and skylights that offer daylight and the hour-to-hour changes in natural light.
By virtue of market pressures to mimic the hospitality industry, and with the emergence
of models of care such as the Eden Alternative for elders, attention to the natural
environment has become a standard of design for care environments. Newer facilities
have gardens, some designed to be actively therapeutic while others to be only
aesthetically pleasing. Some have walkways and security for those residents who may
wander. Other gardens are only to be viewed from outside. What is meaningful and
functional for a long-term care resident who is living in a building is quite different from
an overnight visitor of the acute care patient.

Questions to consider:
1. How does landscape architecture serve the clinical objectives that drive a healthcare
organization?
2. How can natural landscapes be integrated seamlessly between the inside of a
hospital, which represents illness, confinement, challenge, and fear, and the outside,
which offers health, hope, and freedom?
3. What kind of research would bring to the fore the greater depth offered by landscape
architects to better inform budgetary decisions regarding nature and recovery?
This is the time to tackle these issues, as the values of healthcare organizations
and the inherent stresses placed on patients and staff demand more attention to
humane care. The beauty of nature, by its very character, is therapeutic. Human pain
and suffering can be eased with views that are inherently hopeful, are readily
accessible, offer enough complexity to engage the mind and spirit, and are appropriate
to the needs of the moment. Bringing clarity and skill to how this can be accomplished is
the challenge in front of each of us who works in this field.

I.2.1.3 Patient comfort

Not surprisingly, noise reduction in hospitals is top of mind in hospital facility
design. Some 71 percent of respondents said that over the next five years noisereducing construction materials would be incorporated into design features. And 60
percent of respondents said they are incorporating noise-reducing materials into patient
room design. Noise reduction is an area of focus because of the increased emphasis on
patient satisfaction and Facility Guidelines Institute (FGI) Guidelines for Design and
Construction of Hospitals and Outpatient Facilities issued earlier this year that has a
new section on acoustics, including the use of noise-absorbing materials and reducing
the amount of hard surfaces in facilities, which can create unnecessary noise, Sprague
says.The FGI is a volunteer-run organization and its guidelines, published every four
years, are used by 40 states as a hospital licensure requirement. Its amazing how

noisy hospitals have become, Sprague says.To that point, 71 percent of survey
respondents said that regulatory requirements are a major influence in driving change to
health care facility design. Another FGI guideline involves medication safety zones to
reduce medication errors. This can include guidelines on lighting, security and access,
Sprague says. Nearly half of survey respondents (48 percent) said they would put more
emphasis on medication safety zones over the next five years.Top features in room
design include wireless technology for staff (71 percent), conversion of semiprivate to
private rooms (69 percent), technology integration (65 percent) and bar coding for
medication administration (63 percent).Other items that could influence patient
satisfaction include individual temperature control (59 percent) and patient control of
room lighting and shades (57 percent). Thats a lot, Hamilton says of the results. The
research shows these are helpful in terms of patient satisfaction.An important aspect of
facility design these days is energy efficiency because it can reduce overhead costs,
some experts said. For instance, 68 percent said better energy usage and efficiencies
were a major influence in driving changes in facility design. However, just 37 percent of
respondents said that selecting environmentally friendly materials was a major influence
in design.Energy is the biggest opportunity to make an effect on the financial well-being
of a hospital, says Quirk. It gives you better control over swings in commodities like
gas, water and electricity. Hospitals and health care organizations need to push the
industry and, on the client side, clients need to be willing to take professional
recommendations and step up and take a little bit of a risk.

CHAPTER 3
I.3 RESEARCH METHODOLOGY
I.3.1 RESEARCH METHODOLOGY DESIGN
In using different methods in the research we can gather different types of data
that can give multiple views of analyzing the research better. Case studies as a method
of obtaining data from the existing site are used by making a detailed study of the
facilities. Different methods of obtaining information like observation and interviews and
consulting with knowledgeable people are used to gain insights on the problems.
I.3.2 RESEARCH DESIGN: CASE STUDY EXAMPLES
I.3.2.1 Childrens Hospital at Montefiore (CHAM) - INTERNATIONAL
The Childrens Hospital at Montefiore CHAM was specifically designed to provide a
healing and aesthetic setting for pediatric care.
Reflects both the philosophies of family-centered care and the teachings of Carl
Sagan, stressing our connection to the larger whole of the universe and making the
hospital a place where the journey is not only towards healing, but also knowledge.
Throughout the hospital, the child is the centerpiece and driving force behind the
design. The concepts of journey and connection are explored on each floor using
different themes and depicted through numerous art installations. Local and nationally
known artists were handpicked to develop each floors pieces around a specific idea
geared either to the developmental level or illness treated on that floor.
These initiatives at The Childrens Hospital at Montefiore (CHAM) and, help
promote well-being among patients, family members and associates by reducing
stressors such as noise, glare and clutter; connecting

patients and associates to nature; offering beauty and positive distraction through visual
art; and providing space and seating layouts that encourage visitation by family and
friends.

I.3.2.2 St. Luke's Medical Center Global City LOCAL

St. Luke's Medical Center - Global City's
wellness-centered infrastructure, state-of-the-art
medical technology and hotel-like ambiance - all
combined to help deliver an exceptional patient
experience.
The exterior of the hospital projects a
modern building with its strong linear elements
and bold horizontal and vertical features. The materials and color schemes gives us an
impression of a state of the art treatment facility.
The hospital tries to inject landscape greeneries
to soften the design and blend well with the
surroundings.
The hospitals lobby is very generous in
terms of space that it can accommodate large
traffic of people going in and out of the hospital.

The combination of artificial lighting, natural

lighting, and light colored materials gives the
interiors the necessary brightness inside the
hospital to add to a more spacious feel. The
hospitals interior design includes warm woods
and nature-inspired elements and soft color
schemes.
The width of the hallways of the hospital
are wide enough to accommodate patient traffic
and not cause stress due to congestion inside.
Spaces are located along the corridors to serve
as breaks to the otherwise long pathways. These
spaces tend to serve as lounging areas for people
attending to their hospital needs and services.

The hospital keeps their clinical

departments patients very relaxed as lounge
areas outside of the departments have been
created for the people to use while doing their
business with the clinics. There is ample lighting
in the area to give it a bright spacious feel for the
patients and clients.

The hallways for the doctors offices are

also wide which does not compromise the patient
traffic in the area where consultations are ongoing. The hallways have one side for waiting
areas of the patients for consultations.

The hallways have vistas overlooking a

pocket sky garden outside so as to give the
passersby visual breaks inside the building. The
hallway uses glass walls as alternative to let
natural light in to brighten up the area where
people can lounge when waiting.

Aside from the vistas provided by the

gardens outside the hospital also utilizes artworks
to serve as visual stimulations for the patients and
people doing their business inside the hospital.
These are one of few strategies of the hospital to
redirect their attention to more pleasant
stimulations of the patients rather than being
stressed with their medical procedures and
businesses.

I.3.3 RESEARCH DESIGN: CASE STUDY

OSPITAL

NG

TAGAYTAY

Ospital ng Tagaytay was inaugurated on

April 25, 1997 and was opened publicly on
May 4, 1997. It was dedicated to the people
of Tagaytay as well as nearby communities
to provide primary care as well. The planned
city health center and a lying in clinic was
converted into a hospital and is now the
Ospital ng Tagayaty located at Bacolod St.
Kaybagal South, Tagaytay City, Cavite.
The first time the researcher saw the
hospital from the other side he didnt
immediately think it was a hospital because
of its exterior facade. If not for its signage
that tell you its a hospital you might think its
just another government or private building.

The back of hospitals serves as

parking spaces for their ambulance and
some

hospital

employees

while

being

storage for their medical wastes and other

supplies. I immediately noticed the lack of
disposal and storage facility for their medical
waste which is just placed beside the wall
without

precautionary

containment.

coverings

or

When the researcher looked for the

public toilet in the ground floor the first thing he
saw was the cleaning materials and trash cans
located beside the toilets. There is no visible
storage compartments for these cleaning
materials and the risk of contamination is
evident in the area.

Near the toilet area was a breast

feeding and lactating station and it was near
the exit to the back of the hospital. The air
tanks are just located along the corridor and
there is no storage area than can be located to
safely store the tanks. This is a hazard
considering it is located near the breastfeeding
and lactating area and its waiting area where
patients like mothers and their newborn
children are exposed to these safety hazards.
The hall ways is lit by natural light but can be
only appreciated nearing the exit of the
hallway. The width of the hallway is enough to
accommodate the human traffic of waiting
patients, passersby and some equipments but
on a busy day in the hospital this area could be
crowded and become a source of stress
especiall to the patients like the mothers and
their new born babies.

The

laboratory

department

can

only

accommodate one patient at a time in terms of

collecting samples from the patient. When you open
the door you can immediately see the patients chair
with a table for the equipment and materials for
extracting samples from the patients. It is a bit of the
problem for employees and patient traffics since it is
the only door for both laboratory employees and
patients to pass through. A secondary door leading
to the laboratory itself is seen near the patients chair
that could be a hindrance for passersby when there
is an ongoing collection of samples being done.

The laboratory itself is quite small just enough

for making tests that are within their current capability
and capacity.

The other side of the laboratory is a make shift

storage and equipment area. The space allocated for
the laboratory services is not enough if ever they
decide to upgrade their equipments. The spaces and
furnitures needed to house different equipments and
materials are already utilized.

The internal medicine consultation room and

ob-gyne consultation rooms are housed in one area
where they separated by cubicles inside. The spaces
allocated for these services are limited that the
doctors/ consultant doctors dont have enough room
to conduct proper consultations. The rooms for these
services are not confortable and inconvenient for the
physicians and patients because of the lack of space
and privacy needed for the consultations. Because
consultation rooms are made as cubicles sound
insulation is very poor inside.

The central sterilizing and supply room is the

storage room for the supplies needed in the hospitals
such as fluids, personal protective equipment and
other hospital supplies. It is tha main sourcing facility
for the hospitals materials. Unfortunately the space
for the supplies are almost full and inadequate for

inventories of certain duration. There is littlee room

to operate for two staff members working inside.
Due to the inability of the central sterilizing
and supply room to accommodate other materials,
the space beside the main stairs has been
converted to a storage facility of Intravenous fluids
(IV fluids) These is located across the supply room
which is a few meters away.

The emergency room is located near the

xray room but some of its facilities are not up to the
minimum hospital standards such as the current
design and condition of the doors. The access of
patients to be confined from the emergency room is
slightly obstructed by the patients waiting along the
Out-patient department clinics. The people waiting
along the corridors is mixed with patients from the
Out-patient Department, patients coming out of the
emergency room and even the company of the
patients.

The X-ray room has a very cramped office

space that the desk of the technician and attending
staff is almost obstructing the way where a patient
will pass through. Patient on wheelchairs can have
a stressful time navigating inside the narrow space
going through the room.

Some of the nurse stations are unmanned

and not well lit so whenever patients within the area
are in need of the attention of nurses they would
have to go to other nurse stations to seek
assistance.

The

emergency

room

is

capable

of

accommodating from 4-5 patient in its area. But the

problems I noticed is the lack of space for the
equipment.

Equipments

not

used

inside

the

emergency room are only stored at the sides of in

corners within the emergency room.

Inside the pharmacy office there is no clear

separation for the staff working inside and the
storage areas for the medicines. The spaces for the
storage of medicines are almost full and there is a
need to expand more space to accommodate other
inventory of medicines.

The counter for the hospital pharmacy is

located at the hospital entrance. In this picture the
counter for the pharmacy is located right beside the
security guard manning the entrance which looks
inconvenient to the patients especially when there is
build up of lines.

People may have a hard time looking for

location of departments inside the hospital because
of lack of centralized maps. They have to depend
on signages on the walls and assistance of
available hospital staff for their way finding inside
the hospital.

Some hallways appear to be dark and not

very well lit with artificial lighting which may
discourage the people from entering the area
because it appears unused.

Since the hospital is a 2-storey building they

provided a big ramp for transporting the patients to
the second floor where the different wards are
located. Only depending on natural light it appears
to be insufficient for the area which makes it dark.
The

hospital

administrator

says

that

in

an

occurrence of death in the wards there is no other

way to bring down the dead body but to pass
through the ramp which is adjacent to the front
entrance

of

the

hospital

and

Out-patient

departments. A dead body being taken out of the

hospital

passing

through

these

areas

is

an

unpleasant sight for the patients whenever they are

seeking medical attention in the hospital.

The

unused

counter

was

used

as

temporary storage facility for oxygen tanks which is

very dangerous. There should be proper and safe
storage for oxygen tanks and other equipments that
can pose a risk to safety.

The childrens ward offered a playful and

friendly ambiance for the young patients by painting
the walls with recognizable and fun characters to
serve as pleasant vistas.

The hallways along the wards are dark when they only depend on the natural
light. The colors are plain and comply with the minimal required clean image of the
facility without thinking further of enhancing it to make it more therapeutic.

The single bed patient room was located at the

middle part of the floor of the building. It felt stressful
that the patient is surrounded by the walls of the
hospital

without

any

external

access

to

the

surroundings. The importance of having natural

environments at least to one side of a space can
enhance the therapeutic effects of the hospital.

The government building does not satisfy the

minimum requirements of the Fire code of the
Philippines in terms of fire exits. From the door used to
the signages there could be more improvement in the
safety of the patients if the codes are followed.

The childrens pediatric department is just near

the entrance and adjacent to the main ramp where inpatients are brought to the second floor wards. This
poses a risk to the young patients in terms of possible
infections since they are the most vulnerable to
infectious diseases.

The good thing about this space is that

the hospital tried to blend some positive space
in the hospital where the patients can have
pleasant views inside the hospitals and where
people can stay besides from the hospital
areas. The bad thing about this space is that
they did not enhance the potential of this space

to help the patients and people inside the hospital.

The front grounds of the hospital also serve as the areas for parking for
the visitors. Other parking areas are on the perimeter side of the compound which is not
safe for parked cars.Other parking areas are located on the sideIn emergency cases in
the hospital need to have clear and free from obstruction emergency bays.

I.3.4 Behavioral Analysis:

IN-PATIENT:

In

Emergency

Laboratory
and other
Tests

Admission

Private
Room/Ward

Cashier

Out

Laboratory
and other
Tests

Admission

Private
Room/Ward

Cashier

Out

IN-PATIENT:

In

Doctors
Clinic

OUT-PATIENT:

In

Out patient
department/
Doctors Clinic

Laboratory and
other Tests

Cashier

Pharmacy

Out

PATIENTS COMPANY:

In

Patients
Room/ Ward

Nurse
Station

Pharmacy

Out

Doctors
Clinic

Patients
Room/ Ward

Nurse
Station

Out

Staff Area

Nurse
Station

Patients
Room/ Ward

Out

Authorized
Station areas

Patients
Room/ Ward

Out

DOCTOR/CONSULTANTS:

In

NURSE:

In

OTHER HOSPITAL STAFF:

In

Staff Area

I.3.5 Research Instrument: Observation

This technique is used when the data is not adequate through the use of
interview and some other method. Observation used direct means of identifying the
current facility of the hospital, the direct means of observation means of studied the
flow, movement of the people in the facility, the use of the spaces and identifying what
is in the facility. To complete this instrument a Site visit is performed to the potential
research area. We identified the interesting and problematic areas and document the
problem for analysis, and taking it to account, the users and proponents of the area
which is the government and the public.

I.3.6 Research Instrument: Interpritative-Historical

I.3.7 History:
Ospital ng Tagaytay was inaugurated on April 25, 1997 by former President Fidel
V. Ramos and Atty. Francis N. Tolentino, former City Mayor. This was opened publicly
on May 4, 1997. It was dedicated to the people of Tagaytay as well as nearby
communities to provide primary care as well. The planned city health center and a lying
in clinic was converted into a hospital and is now the Ospital ng Tagayaty located at
Bacolod St. Kaybagal South, Tagaytay City, Cavite. The hospital has the old and new
wards, which houses different sections. Open for 24 hours, it has the strength of 99
competent and well trained staff and consultants. The hospitals commitment is to deliver
affordable, accessible and informative quality health care to their patients, regardless of
sex, nationality, religion, political, affiliation and economic status. They have a vision of
commited patient-oriented comprehensive health care program through pro-active,
effective and humane hospital services.

Ground floor Facilities:

Second floor facilities:

Outpatient section

Private rooms

Laboratory

Semi-private rooms

X-ray

Ward Rooms

Drug-room/Pharmacy

Records room

Authorized bed capacity of 12 beds

but total inventory of 20 beds

Emergency Room

Labor

Delivery room

Eye clinic

The Local Government Code of the Philippines:

I.3.8 Research Instrument: Qualitative

POPULATION:

HOSPITALS:

Local Government Unit- Tagaytay City

CHAPTER 4
I.4 SUMMARY OF FINDINGS AND ANALYSIS
In this chapter we summarize and analyze the gathered information during the
research methodology phase of the paper. In using the different methodologies to
gather different information about the site and its facilities we are able to systematize
the datas for better anlysis. This chapter will tackles these datas and presentation them
in order to get a picture and further understand the collected information.
I.4.1 PRESENTATION OF COLLECTED DATA
The presentations of data through graphical methods and figures are done in this
study so that the proponent can understand the problem and easily understand the
problem in this study so that the proponent can easily discuss the gathered information.

Hospital Unmet Bed Need

Projected primary and secondary catchment area (P) 201,659

Total Inventory of Hospital beds (IHB) 140 beds

Bed to Population Ratio (BPR) = (IHB / P) * 1,000
= (140/ 201,659) * 1,000 = 0.69

*The standard bed to population ratio is 1:1000 BPR= 0.69 < 1:1000
Projected Bed Need (PBN) = P * (1/1000)
= 201,659 * (1/1000) = 201.65 or 202 beds
Unmet Bed Need (UBN)

= PBN IHB
= 202 140 = 62 Beds

*Based on 2010 Census the projected unmet beds based on the population is 62 beds
In computing for the possible increase of bed capacity of the Ospital ng Tagaytay
we shall base it through the Department of Health ratio of bed to population which is
1:1000. Using the 2010 census we computed for the primary catchment area in which
the hospital is located and the secondary catchment area which have access or is
contiguous to the primary catchment area. Following the computation process stipulated
by the Department of Health we were able to come up of the projected unmet beds for
future expansion of bed capacity which is 62 beds. If the Ospital ng Tagaytay shall
increase its bed capacity based on the data they are allowed to add up to 62 beds.

I.4.2 RESLUTS: INTERVIEW

Ospital ng Tagaytay was originally a city health center and lying in clinic but was
converted to an infirmary hospital. In 2012 the Department of Health (DOH) and
representatives from private hospitals have reached a compromise that will give
healthcare facilities a maximum of 3 years to comply with the government's hospital
reclassification scheme. This agreement allows hospitals to beef up their facilities and
comply with the DOH's new rules on hospital classification based on Administrative
Order No. 2012-0012.
The Ospital ng Tagaytay is currently classified under the General to Level 1
Hospital needing only a Dental Clinic and Blood Station services. 2013 was a good year
for them because of the following achievements that they have done:

With their achievements, the hospital administrator stressed that their hospital
could have done more for patient care and that if their facilities were upgraded to offer
more services they could not provide. Due to their lack of services they had to refer
other patients to other hospitals that offer services outside of their capabilities.
Transferred Patients

76

Referred indigents to other hospitals

34

Total

110

These 2013 statistics show the different cases leading up to the morbidity and
mortality of patients in the Ospital ng Tagaytay and the Tagaytay City Health office. The
cases in terms of morbidity and mortality show that the limitations to what the current
level of service the hospital can provide in terms of the treating these cases. Some
diseases need other types of services and facilities that clearly with the present line up
of services and facilities the hospital does not have.

I.4.3 Presentation of the Collected Data: Strengths, Weaknesses, Opportunities

and Threats (SWOT)
I.4.3.1 Analysis of strength of the facilities:

Very accessible to roads either by public and private vehicles

The site of the hospital is located along the Crisanto M. Delos Reyes
avenue traversing the Mahogany avenue and Tagaytay-Nasugbu
highway.

The hospital have some positive spaces

The current design of the hospital incorporated some positive spaces like
the interior garden to boost vistas and lounging areas.

The hospital takes advantage of the natural climate

As part of their savings programs some areas in the hospital takes
advantage of the natural light instead of using artificial ones. The location
of the hospital presents a great opportunity for therapeutic environments

Child friendly ward

The rooms for the childrens ward were painted with cartoon characters to
make it a fun and kid friendly ward.

The 2nd floor access ramp

The ramp that accesses the second floor is very useful in transporting
patients to their respective wards with its wide pathways and non-slippery
surface.

I.4.3.2 Analysis of weakness of the facilities:

Exterior design
The problem with the buildings design is that it doesnt give an impression
that its a hospital facility. Other than the sign that says its a hospital it
doesnt convey its purpose to the patients that its a building of therapeutic
design.

Interior design
Although the hospital meets the minimum requirements for hospital
facilities, the hospital could have exerted an effort in making the interior
design more therapeutic environment for the patients.

Toilet facilities
The number of toilet facilities are not suitable to the amount of users in the
building. Some of the toilets are already dilapidated and in need of
replacement.

The hospital is not friendly to persons with disabilities

The facilities of the hospital lack appropriations for persons with disabilities
such as ramps and toilet facilities for PWDs

No other ramps
The main ramp to the second floor is the only access for transporting
patients. The problem is it crosses paths with the out patient department
and the main lobby that when an unfortunate death of a patient occurs
other patients and visitors will be able to see the body being taken out.

Fire safety code violations

There are a number of violations in the fire safety code that the design of
the hospital didnt follow and poses a risk in the lives of the people inside
the building

Space allocation and planning

The spaces of the building are not designed for expansion and that when
the administrators plan to add other services to the hospital their only
option is to make a makeshift facility outside of the building.

Lack of landscapes
The exterior of the building lack is landscapes which can help in the
appearance of the building. The only positive space in the hospital which
is the interior garden is not properly landscape.

Lack of lighting
Some areas of the hospital are very dark when natural lighting does not
reach those areas.

Unnecessary noise
The sound minimization or sound proofing in the hospital is not evident in
the areas and it contributes to the unnecessary noise especially when
there are many patients especially children.

In adequate storage spaces

There is a need for more storage spaces especially in hospital materials
and equipment. In some pictures the hospital equipments such as oxygen
tanks are stored along corridor which can pose a risk to the visitors.

Hazardous waste storage facility

The hospital doesnt have any space in the compound for hazardous
waste materials. The wastes were only stored on an open area at the back
of the hospital without any coverings to prevent contamination.

I.4.3.3 Analysis of opportunities for the facilities:

Due to the growing population in the city of Tagaytay and the adjacent
municipalities there is a foreseen growth in terms of patients in the future.

The Ospital ng Tagaytay is the only public hospital in Tagaytay city and nearby
municipalities which gives it a potential for accepting indigent up to middle class
citizens.

There is a good potential for introducing new facilities adapting with technology
for their convenience.

The hospital is located in Tagaytay city which very well known for its good
climate all year round.

The hospital has a potential to add more beds with the current inventory of beds
of all hospitals there is still an opportunity of growth to increase the bed to
population ratio.

Given the climate and environment of the area there is an opportunity to make
the hospital a more therapeutic environment for the patients.

I.4.3.4 Analysis of potential threat for the facilities:

The age of the hospital is very vulnerable to damages when typhoon Glenda
battered the hospital the roof was damaged and the hospital shut down and did
not accept new patients for almost 2 months. Some patients were transferred.

The current capacity of facilities of the hospital may be inadequate when the
surge of patients come in the near future.

Infections and contaminations of the patients is possible without proper

segregation and protection of their facilities.

Services not found on the current capacity of the hospital may affect its image to
the public as a provider of quality healthcare services.

I.4.4 Needs analysis:

The facts and figures given in the study is analyzed and gives the necessary
recommendations to what is needed by the facility to satisfy the goals and objectives of
this
The following are the needs of the hospital:

Propose more spaces to add to the current capacity of handling services and
patients.

Propose new spaces for the new services of the hospital to make it a Level 2
hospital

Propose a new exterior and interior design of the hospital that can promote
therapeutic environments to the patients.

Propose new materials that can help further in the goals of the hospitals and
adapt better in the surrounding environment.

A better design of the facilities that is friendly to persons with disabilities.

Injects strategies in the appearance of the hospital to promote a therapeutic

environment.

Design the hospital to make it more adaptive to the current and future climate of
the area.

I.5 CONCLUSION AND RECOMMENDATION:

In this part of the study the proponent clearly identifies the problems of the
Ospital ng Tagaytay to give solutions and recommendations needed to the ailing
problems of the facility.
Based on the analysis of the gathered data, we determined the strength and
weaknesses of the hospitals facilities. We identified the potential risks and
opportunities of the hospital to decide on what the hospital needs. The hospital
needs to increase its capacity to cater to more patients today and in the future. It

needs more capabilities in handling current cases of illnesses and be prepared for
the future. In its vision of providing committed patient oriented healthcare services
the proponents for the hospital is recommended to subject the Ospital ng Tagaytay
for redevelopment.
In designing of the new Ospital ng Tagaytay strategies must be put in place in
order to make the hospital a therapeutic environment for the patients. In redevelopment
of the new hospital the new facilities must reduce or eliminate causes of stress in the
patients. The new hospital must provide positive distractions and enable social support
to the patient and its immediate families.
There is a good potential for adding more spaces for accommodation of bed
capacities for the growing number of patients in Tagaytay and the nearby areas.
Complying with the Department of Health standards of computing unmet bed
requirements there is still quite a number of beds still needed to suffice the needs of the
primary and secondary catchment populations.
The design of the new hospital must be based on the Level 2 hospital
classification of the Department of health to further enhance its capabilities for current
and potential diseases inherent in the area.

Part II. Research Focus

In this chapter the emphasis on the main focus of the research is stated
and explored to the redevelopment of the Ospital ng Tagaytay. Principles will be
slated on what is the best approach to the design and how its relevance to the target
market would affect the building.

II.1 Rationale
Proposed redevelopment of Ospital ng Tagaytay : Creating therapeutic
environments through innovative hospital design. In this part of the research we shall
focus on innovative approaches in design to create a therapeutic environment for the
users of the hospital. Many studies are linking the hospital environment to healthcare
outcomes, buildings can either make a people sick or help them heal. The Ospital ng
Tagaytay is committed in providing affordable, accessible, and quality healthcare to
their patients. Their mission and vision is to providing quality healthcare services
through patient-oriented facilities and services. By adapting national and
international standards of hospital design and injecting new innovations, the new
Ospital ng Tagaytay aims to promote a reliable, modern and therapeutic
environment for their users. This research aims to show the potential of the hospital
of reaching more patients in the city and neighboring municipalities but also also
expand it capabilities of providing healthcare services to their patients.

II.2 Principles and Relevance to the Project

Therapeutic Environment theory stems from the fields of environmental
psychology (the psycho-social effects of environment), psychoneuroimmunology (the
effects of environment on the immune system), and neuroscience (how the brain
perceives architecture). Patients in a healthcare facility are often fearful and
uncertain about their health, their safety, and their isolation from normal social
relationships. The large, complex environment of a typical hospital further

contributes to the stressful situation. Stress can cause a person's immune system to
be suppressed, and can dampen a person's emotional and spiritual resources,
impeding recovery and healing.
Healthcare architects, interior designers, and researchers have identified four key
factors which, if applied in the design of a healthcare environment, can measurably
improve patient outcomes:

Reduce or eliminate environmental stressors

Provide positive distractions

Enable social support

Give a sense of control

II.2.1 Principles: Noise Reduction

There are two main reasons why hospitals are noisy. First, there are many
noise sources present, and, second, environmental surfaces in hospitalswalls,
floor, and ceilingtend to be sound-reflecting rather than sound-absorbing.
Sounds contributing to the loud noise levels in hospitals come from mechanical
equipment in usealarms, paging systems, telephones, computer printers, ice
machines, staff conversations, and noises generated by roommates and visitors.
Many studies have found that staff conversation in particular is a major source of
loud noises on the hospital unit. The presence of hard sound-reflecting surfaces
in the hospital tends to aggravate the noise problem in hospitals. Soundreflecting surfaces cause noise to propagate considerable distances, traveling
down corridors and into patient rooms, and adversely affecting patients and staff
over larger areas. Sound-reflecting surfaces typical of hospitals cause sounds to
echo, overlap, and linger or have long reverberation times Reverberation is the
persistence of sound in an enclosed space, resulting from multiple reflections
after a sound source has stopped. Extensive use of sound-absorbing material will
mean that the sound is absorbed and, thus, prevented from building up. When
acoustic conditions are characterized by long reverberation times, echoes will

cause blending and overlapping of sounds, resulting in reduced speech

intelligibility. To make themselves heard staff members then need to raise their
voices, thereby compounding the noise problem even further.

II.2.2 Principles: Access to Daylight

At least 11 strong studies suggest that bright light is effective in reducing
depression among patients with bipolar disorder or seasonal affective disorder
(SAD). A majority of the studies have examined the impact of artificial bright light
in reducing depression. Artificial light treatments usually range between 2,500 lux
and 10,000 lux. The treatment is believed to be effective by suppressing the
onset of melatonin. Two studies have shown that exposure to natural bright light
is similarly effective in reducing depression. Benedetti and colleagues (2001)
found that bipolar depressed inpatients in east-facing rooms (exposed to bright
light in the morning) stayed an average of 3.67 days less in the hospital
compared with similar patients who stayed in west-facing rooms.
Exposure to daylight reduces depression among patients with seasonal
affective disorder and bipolar depression. It helps decreases length of stay of
patients in hospitals. It also improves sleep and circadian rhythms and lessens
agitation among dementia patients, ease pain.
Lighting in healthcare settings
Provide windows for access to natural daylight in patient rooms, along with
provisions for controlling glare and temperature.
Orient patient rooms to maximize early-morning sun exposure.
Assess adequacy of lighting levels in staff work areas.
Provide high lighting levels for complex visual tasks.
Provide windows in staff break rooms so staff has access to natural light.

II.2.3 Principles: Artificial Lighting

The lighting of hospital tasks is important as is the lit appearance of the
interior. There can be a conflict of requirements. On the one hand, there are high
technology and critical tasks, some of which can have life or death implications.
This suggests a crisp high-tech appearance, which will stimulate staff to a high
level of performance. But on the other hand, the patients, particularly as they
recover, may require a softer approach bordering on a domestic impression.
This same sort of conflict is shown in entrance and reception areas. The
patient or visitor arrives wanting reassurance about the quality and care level of
the hospital.
This can be demonstrated by the quality of the interior design, which
includes the way the space is lit. But they also need to have clear direction to the
reception desk, perhaps by making it the brightest part of the scene; here they
are welcomed and directed to where they need to go next. If the lighting scheme
is well designed, some of the apprehensions will be alleviated. Also if they have
to wait in an unappealing space where the lighting has a functional appearance,
they may become agitated and restless a state unhelpful for a medical
consultation or examination.

II.2.4 Principles: Postive Distractions in Hospitals

When people refer to their healthcare experience, they typically (and
correctly) note their experiences in the examination, treatment, and recovery
rooms as well as interactions with the caregivers and support staff. However, it is
common knowledge that a sizable proportion of a patient's and the
accompanying family members' time are spent waiting. Today's planners are
paying considerable attention to waiting time as well as waiting spaces. After allfrom a lean process perspective-any waiting time is a waste that should be
purged from the system. While a wait-free healthcare model does not exist, the

time people spend waiting is increasingly being acknowledged as a crucial

aspect of the overall healthcare experience, with a general appreciation that the
waiting period is not the best part of the healthcare experience for patients and
families.
Studies are providing more information on the waiting experience. A 1996
article, published in the Annals of Emergency Medicine, reported that it is not the
actual wait time, but the perception of wait time that is the determining factor in
patient satisfaction. The International Journal of Research in Marketing
subsequently reported that the attractiveness of the waiting environment has a
greater role in contributing positively to the waiting experience, as compared to
reducing the objective waiting time. A 2008 report from Cornell University further
articulated the potential association between the quality of the waiting
environment, the perceived waiting experience, and the overall healthcare
experience. Sets of independently collected data on environmental attractiveness
and a host of perception measures from actual patients in six clinic waiting areas
demonstrated significant correlations between the attractiveness of the physical
environment and perceived waiting time, perceived care quality, level of anxiety,
and quality of interaction with staff.

II.2.5 Principles: Enable Social Support

Patients and visitors often perceive hospitals as scary, intimidating, and
isolating places. Aside from uncertainties associated with illness, aspects of the
hospital environment itself may generate feelings of uneasiness and heighten
stress levels.
Providing patients with social support can lessen stress, reduce
fear/anxiety, improve outcomes, and stimulate healing. Specifically, Social
support may reduce the amount of medication required, accelerate recovery, and
facilitate compliance with prescribed medical regimes. Providing patients with
social support may also help patients take their mind off of their serious medical

conditions and promote feelings of usefulness. Plus, family-centered spaces are

associated with decreased length of stay, fewer medication errors, and fewer
falls. In conclusion, the presence of family and friends during hospitalization is
beneficial to the patients physical, social, emotional, and mental well-being.

II.2.6 Principles: Colors

It has been suggested that color has a therapeutic effect, although few
empirical observations exist. From daytime to night-time and through all seasons,
the colour of theinterior needs to be attractive and relaxing without being too
stark. The selection of colours for this area is not easy, as all colours will have to
be tested under the light sources installed or planned to be used in this sector of
the building. Some beige or neutral tones can take on very unattractive green or
orange hues under different types of lighting. What appears to be a very soft and
neutral decor by day can turn into an unpleasant colour at night.
II.2.7 Principles: Landscaping
Findings from several studies of non-patient groups suggest that even
brief visual encounters with real or simulated natural settings can elicit significant
psycho-physiologic restoration within as little as 3 - 5 min. This restoration is
manifested as reduced negative effects, and heightened positive effects and
changes in physiology systems that are indicative of reduced arousal or stress
mobilization

(electrocortical,

cardiovascular,

neuroendocrineand

musculoskeletal). Accordingly, Sherman et al. focused on the activities of the

users in the hospital, and found that 66% of staff garden usage was in the form of
walk-throughs from one place to another. Although this activity does not fully
exploit the gardens to their full capacity, research such as Kaplans on microrestorative experiences suggests that even these brief encounters may enhance
staffs well-being and job satisfaction, both of which are predictors of patient
healthcare satisfaction.

II.2.7 Relevance Therapeutic environments in the hospital: Ospital ng

Tagaytay
The relevance of applying therapeutic environments in the design of
hospitals is to create environments where the patients experience an wholistic
care of mind and body. Aiding the pschiatrical therapy with physical treatment of
the patients increases the effectivity of hospital treatments. The Ospital ng
Tagaytay is committed to a patient-oriented healthcare by providing a
comprehensive approach through innovative, pro-active, effective and humane
hospital services.
The hospital aims is to further expand its capabilities and capacities in
providing healthcare to its users. This is a perfect avenue to introduce new
strategies in trying to connect the link of the physical environments to the patients
welfare.
In trying to achieve a therapeutic environment for the patients the design
of the hospital focuses on the factors that give stress to the mental and emotional
state of the patient. Designing the external and internal environments of the
hospital to promote therapeutic effects to the patient can increase ones success
of getting well from an ailment.

II.3 APPLICATION OF THE PROJECT.

II.3.1 Exterior Design
Hospitals designs are not commonly known for pleasure mostly because
people visiting this type of building are seeking for medical treatment. Normally,
hospitals are very simple and minimalist in design, either: we think of over-lit and
sterile environments, with visual stimulation limited to small, wall-mounted
televisions.

However, a new generation of medical facilities is changing the face of the

hospital design. These places take a more holistic approach to healthcare one
that takes the therapeutic environment into consideration. As a result, hospitals
are becoming more welcoming and diverse than those with which many are
familiar.

The design of the Ospital ng Tagaytay tries to be a contemporary building

for its medical facilities when it was first built by the proponent. However in
todays changing design of hospitals it cannot keep up with the new trends in
therapeutic environments. The facade of the building is probably the most
important part of the hospitals appearance as it immediately gives the impression
of what kind of services a hospital can give. By applying new trends in hospital
design and materials they can already set the tone to the prospective patients
that the hospital is state of the art with patient-oriented facilities offering
therapeutic environments to the people.
The design of the hospital must work with the environment that it is in.
Tagaytay is situated in a high area and the climate is appeling almost all year
long. Applying modern tropical architecture to take advantage of the climate in
the area could help both the hospital administrators and the patients in reaping
the benefits of the good weather in the area. Modern materials such as glass and
wall panels/cladding are a welcome addition to the exterior design of the hospital

as it offers a fresh look to the building. Using stainless or rust resistant materials
are recommended in the buildings materials because of Tagaytays cold climate.

II.3.2 Noise Reduction

Research suggests that environmental interventions may be effective in
reducing the noise levels in hospitals and improving the acoustical environment.
Key interventions include installing high-performance sound-absorbing ceiling
tiles, eliminating or reducing noise sources, and providing single-bed rather than
multi-bed rooms
Sound-absorbing ceiling tiles
At least three studies have shown that installing high-performance soundabsorbing ceiling tiles and panels results in reduced noise levels and perceptions
of noise and impacts other outcomes such as improved speech intelligibility and
reduced perceived work pressure among staff. Though decibel levels were not
greatly reduced as a result of the ceiling-tile intervention in these studies
(reduction of 3 to 6 dB(A)), reverberation times and sound propagation were
significantly reduced. This impacted the perception of the unit being less noisy
and also improved speech intelligibility, which has implications for staff
communication.

Reducing noises from floors

By far the most effective way to reduce impact noise from above is to lay
carpet with thick padding underneath the thicker, the better. This dissipates
the impact energy before it has a chance to enter the building structure as sound.
Carpeting gives superb results and often resolves the problem of impact noise.
Resilient Underlayment with Damping Compound If you have impact noise
but carpeting is not feasible in your case, or is something you'd prefer to avoid,
then you'll want to put down layers of flooring that include resilient underlayment
and damping compound. The resilient underlay introduces a decoupling effect,
and the damping compound further dissipates the sound energy, and is
especially important at lower frequencies where underlayment does not help.
You will also have the opportunity to choose materials that provide
additional mass, introducing a third soundproofing element that is especially
important if airborne noise (such as voices or music) is also a concern. (If your
existing subfloor is already substantially massive, such as a concrete slab,
adding additional mass will not accomplish much and won't be necessary.)
Resilient

Underlayment:

There

are

several

varieties

of

resilient

underlayment material available, including foam, fiber, cork, and rubber. A

shredded rubber mat is an excellent choice because it is heavier than foam or
cork, so it gives you the extra soundproofing benefit of added mass.
Damping Compound: The damping compound (typically Green Glue Noise
proofing Compound) can often be applied directly onto the existing subfloor layer,
if the subfloor is not thick and massive, and it is of a material that can be screwed

into. Since the damping compound needs to be between two stiff surfaces to do
its job, a rigid layer needs to be placed above it. You can use cement board, or if
total thickness is not a concern and you want the extra mass for more sound
isolation, you can use thicker sheets of medium-density fiberboard (MDF) or
oriented strand board (OSB). Any sheets that have damping compound between
them should then be screwed together.
Flooring: Install your choice of finished flooring (such as hardwood, wood
laminate, or tile) on top of the underlayment as a floating raft in other words,
do not attach it to the layer beneath with nails, screws, or adhesive. Also, leave a
gap between the edge of the flooring and each wall, and fill the gap with acoustic
sealant. This gap allows for expansion of the flooring, and also acts as a
decoupler, helping reduce the sound energy that is transmitted through the walls
into the building structure (the "flanking noise" problem).

II.3.3 Artificial Lighting System

Reception Area fixed downlights are used for general lighting. To guide
visitors to the reception area, accent lighting is used to illuminate the back wall,
whilst suspended luminaires are used for task lighting above the reception desk.
In daylight areas, daylight regulation is used to save energy by using a daylight
sensor.

Corridors A space where patients often meet each other and talk while
navigating their way through different parts of the hospital, this solution for
corridors in hospitality areas features LED lighting. It ensures that lighting brings
high efficiency in terms of guidance, safety and comfort, while at the same time
having diffused lighting without glare.
Lighting plan

Waiting Room In this standard lighting solution, contrasts are creared to

stimulate interaction between people and to give the waiting area a friendly
dynamic. This has been achieved by the use of downlights. Where the luminaires
are placed near the wall, a pleasing play of light beams is visible.
Lighting plan

Examination Room In an examination room accurate color rendering in

the lighting is of vital importance. This standard lighting system can be adjusted
to suit the activity whether calming, to assist with patient conversations or
brighter task lighting for examinations. Different presets for different

lighting

levels can be pre programmed and this scheme includes an additional LED
examination light, featuring high color rendering with no heat output.
Lighting Plan

Imaging room this room uses LED downlights that provide effective
general white light with very low energy consumption. In additions the system is
fully dimmable using DALI controls and this solution provides a very comfortable
feeling in the imaging room
Lighting plan:

Patient Room to create a comfortable and warm ambience, a luminaire

with a gentle light and soft appearance has been selected to meet the needs of
patients and comply with requirments for patient rooms. In addition, there is a
wall mounted reading light which can be controlled by the patient. In the
evening, a downlight above the table makes the space more open and inviting for
visitors, plus an additional task light is provided above the table.
Lighting plan:

II.3.4 Accessing Daylight:

Access to sunlight will depend on window orientation and on
overshadowing by obstructions. In general, spaces lit solely by windows facing
within 45 degrees of due north will be perceived as poorly sunlit. Windows within
90 degrees of due north are also likely to give little sun if there are significant
obstructions to the south. For many low-dependency hospital spaces, curtains
are the common shading option. Metallized fabrics are available which can reflect
extra solar heat to the exterior and provide some extra insulation at night. For
maximum daylight, it should be possible to pull the curtains fully back so they do
not obstruct the glazing. Louvered blinds give better control of sunlight; often the
blind can be adjusted to block sun but permit some view out. They are harder to
keep clean, but provide good glare control, especially in non-clinical areas. The
most hygienic option is to use mid-pane blinds in a sealed double-glazing unit.
Mid-pane shading also rejects more solar gain than an equivalent interior blind.
In spaces with significant window area, extra shading may be required to prevent
overheating in summer. Horizontal shading above the window, such as awnings,
overhangs or canopies, can block high-angle summer sun while allowing winter
sun and a view out. High performance glazing is now available which can give
reduced solar transmittance with a higher daylight transmittance.
Sunlight in outdoor spaces around the hospital is also valued, both for
sitting out and to give pleasant views from inside. Asked if they would prefer a
pleasant sun-lit view with no indoor sun rather than indoor sunshine with an
unpleasant view, 50% of patients opted for the view. Courtyards, particularly
deep ones, are generally poorly sun-lit unless they are opened out to the south.
Lighting in healthcare settings
Provide windows for access to natural daylight in patient rooms, along with
provisions for controlling glare and temperature.
Orient patient rooms to maximize early-morning sun exposure.

 Assess adequacy of lighting levels in staff work areas.

Provide high lighting levels for complex visual tasks.
Provide windows in staff break rooms so staff has access to natural light.

II.3.5 Positive distractions inside the hospital

Positive distractions refer to a small set of environmental features or
conditions that have been found by research to effectively reduce stress.
Distractions can include certain types of music, companion animals such as dogs
or cats, laughter or comedy, certain art, and especially nature. The focus here is
on the last, nature.
Design strategies in providing positive distractions inside the hospital are the ff:

Views of nature, from patient rooms, and wherever possible in lobby,

waiting, and other 'high stress' areas

Access to nature, healing gardens Chapel, meditation room, and

meditation gardens

Artwork depicting nature, including back-lighted photographs of nature

Mild physical exercise; corridors, public spaces, and gardens that invite
walking when appropriate

II.3.6 Enabling social support:

Many studies have demonstrated how social support can improve health
related outcomes. Studies have shown a general positive association between
the overall number of social ties or contacts people have and their health status.
Research has shown that in a range of healthcare and non-healthcare settings,
people who receive higher levels of social support, tend to be less stressed and
have better health status than more socially isolated people.
Design strategies that promote social support are the ff:

Spaces should be flexible and easily controlled by patients and families

in order to adjust to situational needs.

Provide patients with single rooms, with designated family areas

Provide family lounges and waiting areas near patients

Create a confortable environment by incorporating soft finishes,

furnishings and materials into the design.

Use technology to foster social support

Provide natural gardens for patients and families to use

II.3.7 Therapeutic effects of Colors

A perfectly crafted color palette can do wonders for a healthcare facility,
whether its the product of a new-build project, renovation, or just a bit of
rejuvenation.

But determining what shades of paint are best suited for a specific space should
be done with plenty of consideration for not only facility type, but also the
area/department being painted and the individuals who will be using it.

White walls are often associated with a clinical appearance and

institutional settings. Adding color and an interesting ceiling design, as
in this procedure room, can make the environment seem less
intimidating.

Color may be tied to the institutions logo or corporate brand

Art can create an analogous color scheme in hospitals

Here several colors of various hues, but similar in value,combine to

create a warm environment and visually shorten a long corridor.

Signage is sometimes overused in healthcare.Small accents of color

may play a role in attention grabbing assisting as a wayfinding cue.

II.3.8 Landscaping
Landscaped grounds - Green areas between buildings, primarily used for waiting
and eating in, link the architecture with walking paths; however, they may be
expensive to maintain.

Landscaped setbacks - These are usually planted areas in front of the main
entrance, which are visually pleasant and serve to separate the hospital building
from the street.

Courtyards - Courtyards are the central and most often used spaces in a hospital
building complex, because of their proximity to the dining area; they tend to be
used more by visitors and patients if they are easily visible, and should be
sufficiently large to prevent overcrowding. Courtyard features may include
landscaped tree-shaded areas, water features, flowerbeds and moveable seats;
for reasons of privacy and security as well as aesthetics, they may be fenced
around (especially if designed for care of the mentally ill) up to a height of 4.27m.

Roof gardens - Gardens located on roofs are visually attractive, enabling

patients to look out from their rooms and have a comforting view of grass,
paving stones, benches and people, rather than roofing material or medical
equipment. Depending on how much planting material is used and to what depth,
green roofs generally weigh between 6.82kg and 22.73kg per square foot. They
are a practical and sustainable way of regulating the quantity and speed of runoff, as they retain 70-90% of the rainwater that falls on them in the summer, and
35-40% of the precipitation in winter [18]. Roof gardens enable major energy
savings that will more than compensate, in time, for the costs of building,
structure, waterproofing, and landscape maintenance; and they also minimize the
environmental impact of a health care facility.

Viewing gardens - Some health care facilities with limited space and budgets
feature a small, enclosed garden that can be seen but not entered. Such gardens
cost little to maintain, provide some green space, flowers, perhaps a water
feature, and they can be seen from sheltered indoor seating areas; however, the
elements of nature they provide are removed from the senses, as they cannot be
approached smelled, heard or touched.

Part III

Site

Identification and Analysis

Chapter III.1 Site Evaluation and Analysis
III.1 Criteria for site selection
In this chapter, the site of the Ospital ng Tagaytay is being analysed and identified, the
characters of the site based on the progression and undesirable characters are being
identified in terms of the macro setting and micro setting. Specific laws and ordinances
are stated according to the particular area.
III.1.1 The Macro Setting

Location of Site

Tagaytay,
officially
the City
of
Tagaytay
is
a component
city in
the province of Cavite, in the Philippines. It is one of the country's most popular tourist
destinations because of its outstanding scenery and cooler climate provided by its high
altitude. Tagaytay overlooks Taal Lake in Batangas and provides one of the iconic
views of the Philippines, the view of Taal Volcano Island in the middle of the lake,
viewable from several vantage points in the city.

Boundaries of Tagaytay

Tagaytay is relatively close to the capital city of Manila, only 55 km (34 mi) away
via Aguinaldo Highway, providing an easy escape for the locals from the heat of the big
city.
Tagaytay City has a total land area of 66.1 km2 (26 sq mi) which represents about
4.37% of the total area of the Province of Cavite. It lies within 120 56' longitude and 14
6' latitude and overlooks Manila Bay to the North, Taal Volcano and Lake to the south
and Laguna de Bay to the east.
III.1.2 Land Area

Land Capability Map

The southern and eastern portions of Tagaytay City are covered by hills and mountains
which is generally forests and open grasslands. The city lies along Tagaytay Ridge,
a ridge stretching about 32 kilometres (20 mi) from Mount Batulao in the west to Mount
Sungay (now People's Park in the Sky) in the east with elevations averaging about 610
metres (2,000 ft) above sea level. Mount Sungay, in Tagaytay, is the highest point of the
province of Cavite at 709 metres (2,326 ft).
III.1.3 Topography

Soil Suitability Map

The ridge, which overlooks Taal Lake in Batangas province, is actually the edge of Taal
Caldera. The 25-by-30-kilometre (16 mi 19 mi) wide cavity is partially filled by Taal
Lake.[6] Tagaytay's built-up areas including the urban center is situated in the relatively
level top of the caldera rim but beyond the edge are deep ravines that drop straight
down
to
Taal
Lake.
The
portions
adjoining
the municipalities
of Mendez, Indang, Amadeo and Silang are level to nearly level areas interspersed with
very gently sloping surface. Across the southern edge of the lake on the opposite side
of the city is Mount Macolod, the highest point of the Taal Caldera rim.

Amended Land Use Plan

Access Road Map

III.1.4 The Micro Setting

Site Location
The site of the current Ospital ng Tagaytay is located on Tagaytay City, near the
Tagaytay City Hall. The site is along Crisanto M. Delos Reyes Street which jeepneys
pass through.

Property Identification Map

Referring to the figureThe site of the Ospital ng Tagaytay is located on Lot 011 which
has an area of 1000 Sqm is adjacent lot 013 having an area of 3722 Sqm. The
redevelopment of the Ospital ng Tagaytay will involve the construction of a new building
which will be erected on lot 013.

Traffic and Noise Analysis

Traffic Analysis

Jeepneys pass along road Delos Reyes (Yellow Line) and so the main traffic is
along this road only. Private vehicles barely pass through this part unless their purpose
is to go to the hospital or to the city hall. The main traffic passes through TagaytayNasugbu Highway which is connected to Delos Reyes Street. Since the hospital and the
site is along a road that is passed by jeepneys, it can be expected that the site is
exposed to a lot of noise from the eastern side.
The immediate vicinity of the site is clear and of open spaces and so there is not
much activity around. Foot traffic therefore is also to a minimum unlike the vehicular
traffic on Delos Reyes Street.

Sun Path Diagram

Wind Path Diagram

III.1.5 Related laws and ordinances

ZONING ORDINANCE for TAGAYTAY CITY
CITY ORDINANCE NO. 97-93 Series of 1997
AN ORDINANCE REVISING THE ZONING REGULATIONS FOR THE CITY OF
TAGAYTAY, PROVIDING FOR THE ADMINISTRATION, ENFORCEMENT AND
AMENDMENT THEREOF AND FOR THE REPEAL OF ALL ORDINANCES IN
CONFLICT THEREWITH. Be it ordained enacted by the Sangguniang Panlungsod of
Tagaytay that:
WHEREAS, the implementation of the Comprehensive Land Use Plan would require the
enactment of regulatory measures to translate its planning goals and objectives into
reality; and a Zoning Ordinance is one such regulatory measures which is an important
tool for the implementation of the Comprehensive Land Use Plan;
WHEREAS, Republic Act No. 7160, otherwise known as the Local Government Code of
1991 authorizes local government units to enact zoning ordinances subject to and in
accordance with existing laws;
WHEREAS, the Housing and Land Use Regulatory Board (HLRB) has spearheaded
and now assists in and coordinates the activities of local governments in comprehensive
land use planning;
NOW THEREFORE, the Sangguniang Panlungsod of Tagaytay, in a session
assembled, hereby adopts the following Zoning Ordinance.
ARTICLE IV
ZONE CLASSIFICATIONS
Section 5. Division into Zones or Areas. To effectively carry out the provisions of this
Ordinance, the city is hereby divided into the following zones or areas as shown in the
Official Land Use ad Zoning Map.
1. Tourism Strip

2. Primary Urban Core

3. Secondary Urban Core
4. General Development Area
5. Agricultural Development Area
6. Ecological Development Area
7. High Density Area
8. Special Conservation Area
9. Ecological-Tourism Area
10. Greenbelt Zone
11. Special Institutional Area

Section 6. Zoning Map. The official zoning map for the entire city, wherein the
designation, location and boundaries of the districts/zones herein established are
shown, are hereby adopted as an integral part of this Ordinance. Such official zoning
maps shall be signed by the local chief executive and duly authenticated by the
Sangguniang Panlalawigan.
Section 7. Zone/Area Boundaries. The locations and boundaries of the zones or areas
into which the city has been divided are hereby identified and specified as follows:
ZONE LOCATION
1) Tourism Strip
2) Primary Urban Core
3) Secondary Urban Core
Roads;

Section 8. Interpretation of the Zone Boundary. In the interpretation of the boundaries

for any of the zones indicated in the zoning map, the following
rules shall apply:
1) Where zone boundaries indicate that they approximately follow the center of the
street or highway, the street or highway right-of-way lines shall be construed to be the
boundaries;
2) Where zone boundaries indicate that they approximately follow the lot lines, such lot
shall be construed to be the boundaries.
3) Where zone boundaries indicate that they are approximately parallel to the center
lines or right-of-way lines of streets and highways, such zone boundaries shall be
construed as being parallel thereto and at such distance therefrom as indicated in the
zoning map. If no distance is given, such dimension shall be determined by the use of
the scale shown in said zoning map.
4) Where the boundary of a zone follows approximately a railroad line, such boundary
shall be deemed to be the railroad right-of-way.
5) Where the boundary of a zone follows a stream, lake or other bodies of water, said
boundary line should deemed to be at the limit of the political jurisdiction of the
community unless otherwise indicated. Boundaries indicated, as following the
shorelines shall be construed to follow such shorelines. In the event of change in the
shorelines, the boundaries shall be construed as moving with the actual shorelines.
6) Where the lot of one owner on record at the effective date of this Ordinance is divided
by a zone boundary line, the lot shall be construed to be within the zone where the
major portion of the lot is located. In case the lot is bisected by the boundary line, it shall
fall within the zone where the principal structure falls.
7) Where the zone boundary is indicated as one-lot-deep, said depth shall be construed
to be the average lot depth of the lots involved within each particular city block. Where,
however, any lot has a depth greater than said average, the remaining portion of said lot

shall be construed as covered by the one-lot-deep zoning district. Provided, that the
remaining portion has an area less than fifty percent (50%) of the total area of the entire
lot. If the remaining portion has an area equivalent to fifty percent (50%) or more of the
total area of the lot, then the average lot depth shall apply to the lot which shall become
a lot divided and covered by two or more different zoning districts, as the case may be.
In case of any remaining doubt as to the location of any property along zone boundary
lines, such property shall be considered as falling within the less restrictive zone.
8) The textual description of the zone boundaries shall prevail over that of the official
zoning maps.
ARTICLE V
ZONE REGULATIONS
Section 9. General Provision. The uses enumerated in the succeeding sections are not
exhaustive nor all-inclusive. The Local Zoning Board of Adjudication and Appeals
(LZBAA) shall, subject to the requirements of this Article, allow other uses not
enumerated hereunder provided that they are compatible with the uses expressly
allowed. Allowance of further uses shall be based on the intrinsic qualities of the land
and the socio-economic potential of the locality with due regards to the appropriate
sustainable development principles and the maintenance of the essential qualities of the
zone. Specific uses/activities of lesser density within a particular zone may be allowed
within the zone of higher density but not vice versa, nor in another zone and its
subdivisions except for uses expressly allowed in said zones, such that the cumulative
effect of zoning shall be intra-zonal and non inter-zonal.