MIL-HDBK-1191
4.3.3.4
Design utility areas for electrical, mechanical, plumbing and
other support systems in such a manner as to permit modifications in
support of medical functional changes with the least life-cycle-cost and
least disruption to the overall operations. Locate utility areas for cost
effective connections to site utilities and efficient distribution to
functional areas. Stack similar utility areas vertically in multi-floor
buildings where feasible for improved distribution. Provide adequate
space for required safety clearances and for maintenance and repair. See
applicable utility sections for additional information.
4.3.4
Atriums/Clinic Malls. Properly designed atriums and clinic
malls improve aesthetic conditions, provide natural light to interior
patient rooms and establish an environment providing psychological
benefits to patients, staff and visitors. The incorporation of an atrium
into the design of a multi-story facility has the potential for reducing
initial capital investment, construction costs, and associated energy
costs. See Section 13, Fire Protection, of this document for fire and
life safety design requirements.
4.4
Circulation.
4.4.1
Separation of Traffic. In a multi-story medical facility,
elevators are a principal axis of personnel, patient and materiel
movement. To reduce the mixing of supplies, visitors, staff and patients,
access to and location of different types of elevators should be
considered. The objectives of separation are to decrease cross
contamination, minimize disturbance of patients, and organize traffic
patterns. Reference Section 17, Transportation and Materials Handling.
4.4.2
Circulation Patterns.
4.4.2.1
Provide adequate circulation space at points of traffic
congestion. Provide architectural features that emphasize overall
circulation patterns and major entrances to departments.
4.4.2.2
Make circulation more efficient by avoiding confusing hallway
systems, the extension of through corridors from department to department,
dead end departmental corridors, and a horseshoe shape in major corridor
systems that require excessive walking distances.
4.4.2.3
Minimize the use of single-loaded corridors.
4.4.2.4
Locate vertical transportation element(s) to be immediately
visible and accessible from the major entrances.
4.4.2.5
Main circulation corridors in health care occupancies should
be at least 2400mm (8 feet) wide, exclusive of lobbies and elevator
vestibules, unless otherwise directed. Minimum corridor widths must
comply with NFPA 101 (reference 4b) requirements. Generally, minimum
corridor widths shall be 1700mm (5 feet 6 inches) and 2400mm (8 feet),
depending on loading and code requirements.
4.5
Floor-to-Floor Heights. Determination of finished-floor to
finished-floor heights is a multi-disciplinary task. Special attention
must be given to mechanical requirements and clearances. Adequate space
shall be provided above finished ceilings for the coordination and
4-3
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