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Mechanical, Electrical, and Plumbing Engineering Systems (MEP) Play a Major Role in Enabling Hospitals to Perform their Functions, and in the Comfort, Safety, and Security of their Occupants. They Affect each other and Influence the Design and Execution of the Building’s Architectural and Structural Elements, including the Layout, Elevations, and Plans, in addition to Aspects Pertaining to Structural Systems or Shafts, and Interior Finishes. The Paper Problem is Apparent through the lack of knowledge Relating to the Requirements of different Engineering Service Systems, and the Unawareness of their Impact on each other or on the Architectural and Structural Elements of the Building. This limits Fully Benefiting from such Systems due to Conflicts between them and the Architectural and Structural Elements, in addition to Hindering Making Appropriate Design Decisions related to Operating them causing Deficient Coordination. This Paper Aims to Develop a Methodology for Achieving Integration between Types of Engineering Service Systems and the Architectural and Structural Elements of Hospital Buildings, Leading to Design Decisions that can Attain the Highest Benefit from such Systems and Ensure their Operational Safety according to their Types, Internal Components, Functional Requirements, and their Impact on the Design Decisions for all the Structural Elements of the Building. This is Performed based on a Theoretical and Analytical Study of the Types and Components of Engineering Service Systems (MEP) and Determining their Impact on the Structural Elements and Architectural Components of the Building. The Paper proposes a Methodology that Comprises 12 Stages to Achieve Integration between Engineering Systems and the Structural and Architectural Elements of the Building, according to the Types and Requirements of each System and its Impact on Design Decisions. A set of Tables are also Developed that Represents a Guideline and include Alternatives to the Different Types of Engineering Systems, their Requirements, and Highlight their Impact on the Structural and Architectural Elements of the Building, including the Layout, Plans, Elevations, and Interior Design Elements, in addition to their Relation to other Engineering Systems. The Results also Highlighted the Large Diversity of Types of Mechanical Systems, and the Significant Influence of Electrical Systems on all other Systems. [ABSTRACT FROM AUTHOR]

This paper presents the critical egress parameters that influence emergency evacuation in a typical hospital building. A parametric study of a 20-story hospital building is conducted using a computer model "Pathfinder" to simulate the evacuation efficiency and assess the influencing parameters. The main egress parameters that influence the evacuation efficiency, including the location of stairways, number of stairways, location of the fire, exit width, and number of low-speed occupants are varied. Two scenarios are simulated: one being the regular (practice) evacuation drill and the other is the actual fire drill. The result shows that the location of stairways significantly affects the total evacuation time with the optimal stairway arrangement consisting of one stairway outside the core of the building. Similarly, the story level at which the fire occurs is another key parameter with fires at lower levels being critical to dictating the evacuation time in a hospital building. The total evacuation time when the fire occurs between the third and sixth floor is found to be 170 min which is 36% and 15% higher than fires at the top story levels (15–18th floor) and the intermediate story levels (9–12th floor), respectively. [ABSTRACT FROM AUTHOR]

• Wall-Frames are appropriate structural system for hospital buildings. • Yield strain limit state of rebar monitored for evaluating Occupiability performance. • Atleast overall 3% SPD should be provided in Wall – Special Moment Resisting Frame. • Minimum column-to-beam strength ratio of 2 is recommended for hospital buildings. In the aftermath of earthquakes, hospital buildings are expected to remain occupiable to treat the injured. For the purpose, firstly, an appropriate structural system that ensures no or limited structural damage should be provided in such buildings; wall-frames are the recommended structural systems in hospital buildings. Secondly, it is also essential to adequately design wall-frames to help meet the preferred Occupiability seismic performance. The work presented in this paper examines the contributing factors for failure of structural elements in hospital buildings and explores structural configuration and design strategies for mitigating these failures. Nonlinear analyses studies of a typical hospital building in high seismic region in India are carried out to help provide quantitative guidelines for: (a) Structural Plan Density (SPD) of structural walls, and (b) design parameters, for achieving the preferred performance. Displacement-based limit state of structural damage adopted from traditional displacement demand estimation rules is proposed. Lateral stiffness, strength, and ductility are evaluated of study buildings, and efficacy of results obtained from nonlinear static analyses confirmed by performing nonlinear time history analyses in commercial software PERFORM 3D. Results demonstrate inadequacy of moment frame structural system in hospital buildings under strong earthquake shaking, identifies optimum overall SPD of structural walls and relative column-to-beam strength ratio of frame members, required to achieve Occupiability. A minimum 3% SPD of structural walls in Wall – Special Moment Resisting Frame (WSMRF), 4% SPD in Wall – Ordinary moment resisting frame (WOMRF) hospital buildings, and a minimum column-to-beam strength ratio (CBSR) of 2 is required in hospital buildings to attain Occupiability performance. [ABSTRACT FROM AUTHOR]

Hospital wayfinding systems that are based solely on signage do not provide adequate solutions for wayfinding needs, especially for users with impairments. Moreover, the interaction between user characteristics and the inner space of the building also determines wayfinding efficiency. The aims of this study, therefore, were to identify architectural features that affect spatial orientation and wayfinding behaviors; demonstrate the implementation of a multi-criteria decision-making (MCDM) approach for improving wayfinding in a diverse range of users; and produce a set of quantitative values (i.e., weights) for each selected architectural feature, based on the individual's preferences. Doing so could enable the formulating of practical design guidelines for hospital buildings, tailored to the needs and abilities of the users, to minimize disorientation and confusion – as demonstrated in this paper through a case study. The MCDM approach was chosen as it is based on observations whereby wayfinding resembles a continuous decision-making process, throughout which, users continuously select those architectural features that they perceive as having the greatest wayfinding value. • Summarized the effects of architectural features on wayfinding behaviors. • Demonstrated multicriteria decision-making processes for improved wayfinding. • Designed inclusive wayfinding systems for a diverse range of users. • Illustrated a process for generating routes that minimize users' disorientation. [ABSTRACT FROM AUTHOR]