Part B - Health Facility Briefing & Design 260 Medical Imaging Unit - General
Part B - Health Facility Briefing & Design 260 Medical Imaging Unit - General
Part B - Health Facility Briefing & Design 260 Medical Imaging Unit - General
Executive Summary
This Functional Planning Unit (FPU) covers the requirements of a general Medical Imaging Unit which
provides radiology and diagnostic investigations to patients. Depending on the level of service and the
clinical service plan, the unit may also provide X-ray in addition to diagnostic screening (fluoroscopy),
ultrasound, mammography, computed tomography (CT), magnetic resonance imaging (MRI) or
interventional radiographic procedures such as angiography.
There are several models of service that include a unit managed by the hospital, a main unit with satellite
units located in the hospital, an independent privately-owned facility within the hospital or a unit located
off-site also known as a Radio-Diagnostic Centre. The Unit located in a hospital may be centralised,
collocated with Emergency Unit or located with Nuclear Medicine and Radiotherapy in a comprehensive
imaging suite.
The Medical Imaging Unit is arranged in Functional Zones depending on the scope of service and imaging
specialties to be provided. Key considerations are structural support, access and services provisions for
equipment selected.
The size of the general Medical Imaging Unit may vary dependent on the service plan, the imaging
specialties to be included and the demand for services. Design Considerations address a range of
important issues including construction standards, acoustics, privacy, space standards, safety and security
and Building Services Requirements.
The Schedules of Accommodation are provided using references to Standard Components (typical room
templates) and quantities for typical Units at Role Delineation Levels (RDLs) 2 to 6.
Further reading material is suggested at the end of this FPU but none are mandatory.
Users who wish to propose minor deviations from these guidelines should use the Non-Compliance
Report (Appendix 4 in Part A) to briefly describe and record their reasoning based on models of care and
unique circumstances. The details of this FPU follow overleaf.
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Table of Contents
Executive Summary ...................................................................................................................... 2
Table of Contents ......................................................................................................................... 3
260. Medical Imaging Unit - General......................................................................................... 4
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provisions for prams and a play area for children. Bed waiting areas should be separated from
the ambulatory patient waiting areas for patient privacy.
X-ray, Screening and Scanning Areas
General X-ray and Fluoroscopy
General X-ray rooms may be clustered with Fluoroscopy rooms in order to share support facilities.
The General X-ray room equipment generally includes an upright stand for chest films. OPG and
Mammography imaging equipment may be included in a General X-ray room where imaging
equipment is not fully utilised. Additional equipment will require a slightly larger room.
If satellite imaging rooms are not provided in the Emergency Unit (EU), a minimum of one General
X-ray room must be sized and located with rapid access for transfer of patients from Emergency
Unit.
Fluoroscopic radiographic imaging procedures involve administration of contrast media to the
patient and the timed use of a fluoroscopic imaging system along with sequential repositioning of
the patient. The Fluoroscopy room requires a preparation room for barium mixtures and an
adjacent toilet/ shower that may be accessed from inside the room or from the external corridor.
Fluoroscopy may be combined with an Angiography room, due to the decreasing incidence of
barium usage. The room should include services for anaesthesia.
Orthopantomography (OPG)
OPG is an orbital X-ray of the upper and lower jaws, displaying teeth on a single film, used in
dental, trauma, and facio-maxillary services. This equipment may be incorporated into a General
X-ray room, a separate bay or within the Dental Unit
Computerised Tomography (CT Scanning)
CT Scanning uses X-ray and computer technology to create detailed digital images, both two and
three dimensional. CT scanning equipment consists of a rotating ring inside a gantry with a sliding
table for the patient. Multiple images are taken in slices which are combined using computer
technology. The CT Scanning room will have an associated Control Room and computer
equipment room.
Refer to the Standard Component for CT Scanning for detailed room requirements. A Control
Room may service 2 rooms. The room should include services for general anaesthesia and be sized
for interventional procedures. A bed/ trolley bay adjacent to each room is required for staff
observation of waiting patients.
Angiography/ Digital Subtraction Angiography (DSA)
Angiography involves x-ray imaging the inside of blood vessels using an injection of contrast
media. Simple angiography procedures such as peripheral studies can be done on fluoroscopy
equipment.
Digital Subtraction Angiography (DSA) refers to a process where contrast media is injected into a
vessel in the area being examined. Images are taken of the blood vessels before and after
injection with contrast media. The pre-contrast images are subtracted from the post contrast
images by computer resulting in clear blood vessel images.
Procedures using this type of imaging include angiography, angioplasty, arterial and venous
stents, biliary and renal artery imaging. DSA procedures are becoming less popular in favour of
CT scanning due to the ability to produce 3D images of vessels using a less invasive procedure.
These procedures may also be performed in a surgical or day-surgical environment depending on
the operational model.
Mammography
Mammography imaging or breast screening may be included for diagnostic purposes according to
the hospital’s operational policies. Mammography rooms should provide sufficient area for
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interventional procedures such as needle biopsy that may require bed access and prone
positioning. Mammography should be located adjacent to an Ultrasound Room for fine needle
biopsies. Change Rooms should be accessible directly from the Mammography room and an
Interview Room will be required in close proximity. Privacy curtains to shield examination area
should be provided.
Stereotactic Biopsy
Optionally, Stetrotactic Biopsy may be provided in the same room or in a separate room to
Mammography. Stereotactic Biopsy occurs for mammography guided breast biopsy procedures
for calcified breast lesions without an obvious associated mass detected either by ultrasound or
mammogram. Privacy curtains to shield examination area should be provided.
Magnetic Resonance Imaging (MRI)
MRI scanning is a non-Invasive procedure using large magnets combined with radio waves and a
computer to receive signals from atoms in body tissue creating detailed cross section images of
organs and vessels. MRI does not use ionizing radiation.
The location of the MRI is important to restrict access, protect the magnetic field from
interference and reduce the extent of electro-magnetic shielding required. Specifically, the MRI
should be located:
With good external access for installing and servicing the equipment; this may be achieved
through an accessible side panel or wall
Distant to any moving metal objects that may cause interference such as lifts, passing cars,
construction equipment
The MRI should not be located below a helipad or next to a sub- station
Facilities required in the MRI suite include:
• Patient change rooms with lockers for personal property (personal property particularly
items with a metallic content must not be taken into the MRI room including watches,
credit cards and keys)
• An Interview Room for patient discussion
• Storage for equipment (non-metallic)
• Control Room
• Equipment Room
Planning and design should consider the following:
Structural assessment is required to ensure the floor/ slab will accommodate the MRI weight
The MRI unit and the associated magnetic field must be fully contained within the room, according
to the equipment selection and specifications, that will require liaison with the equipment
supplier
The MRI room will require magnetic shielding and radiofrequency shielding, to be determined in
conjunction with the equipment supplier, according to the machine specifications
Access control is required to the MRI suite, the MRI room and the support areas within the suite
to ensure authorised entry. Recommended exclusion zones are divided into four stages including:
• Zone 1: Entrance which may be shared with the overall Medical Imaging Unit
• Zone 2: MRI, Reception, sub-waiting, waiting which may be shared, patient screening,
toilet and change room
• Zone 3: MRI post-changing, patient preparation, recovery, control and equipment rooms
• Zone 4: MRI Scanning room
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Equipment and fittings in the room including emergency equipment such as fire extinguishers and
gas bottles need to be constructed of non-ferrous material
MRI rooms are to comply with Standard Components, refer to Standard Component – MRI
Scanning Room, Room Data Sheet and Room Layout Sheet. Where there is more than one MRI,
zones 1, 2 and 3 may be combines for both MRI’s, but zone 4 is separate.
Ultrasound
Ultrasound is a non-invasive procedure using high frequency sound waves for diagnostic
purposes. This permits the use of ultrasound for various types of tissue and organs and is
particularly useful in obstetrics, digestive system, renal, cardiac and vascular scanning. Ultrasound
does not use ionising radiation and does not require radiation shielding.
Ultrasound examinations may be done in the Medical Imaging unit, in specialist units or at the
patient location, as the equipment is mobile. Ultrasound imaging may involve interventional
procedures and room size may need to accommodate additional procedures and access for
patients on a bed/ trolley. Ultrasound rooms require close access to drinking water and a toilet
for particular scanning procedures. Privacy curtains to shield examination area should be
provided.
Support Areas
Preparation Room
The Preparation Room is provided for preparation of contrast media solutions, storage of
medications and sterile supplies. The room should be sized to accommodate the quantity of
supplies required. The Preparation Room, if conveniently located, may serve several imaging
rooms. The Preparation Room shall comply with requirements identified in Standard
Components.
Image Processing Areas
For digital imaging systems, traditional film-based processing areas are replaced by workrooms
for viewing and checking of digital images. The workrooms should be located in close proximity
to the imaging rooms and sized appropriately for the numbers of workstations required.
Digital Image Storage
For digital imaging applications, there will need to be an area for the PACS (Picture Archiving and
Communications System) servers.
A room for filing of patient films may be provided for patient‘s own films and historic films for
research purposes. The film store may be located close to the Reception/ administration areas.
Secure storage areas for archived film may be remote to the Imaging Unit. Film storage areas must
provide a suitable environment to protect films from deterioration and damage.
Staff Areas
Offices and Workstations
Offices and workstations may be provided for the Unit Director/ Manager, Senior Radiographer,
Senior Radiologist and Nurse Manager of the Unit, located in a discreet staff accessible area. The
number of offices required will be determined by the clinical service plan, dependent on the role
and size of the unit.
Reporting Rooms
Picture Archiving Communications Systems (PACS) reporting areas will include Radiologist
workstations for viewing and reporting on procedures using high resolution medically qualified
diagnostic monitors on which images can be manipulated. A minimum of two linked monitors are
required, occasionally four screens are provided.
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In addition to the reporting monitors, a dedicated computer will be required for access to the
Patient Information System and a system for dictating reports.
Locate reporting areas in a quiet area with ready access to the imaging rooms. Several
workstations may be located in one room but will need to be visually and acoustically separated.
Staff Amenities
Staff will need access to the following:
• Toilets, shower and lockers
• Staff room with beverage facilities
• Meeting room/s for meetings, education and training.
1.4 Functional Relationships
1.4.1 External Relationships
The Medical Imaging Unit will have a close relationship with the following:
• The Main Entrance of the facility
• Emergency Unit
• Critical Care Units (ICU/ CCU/ HDU)
• Operating Unit for intra-operative imaging
Inpatients Units
Outpatients Units for the volume of patients requiring diagnostic testing
Radiotherapy/ Oncology for regular patient investigations associated with treatment
The optimum external relationships demonstrated in the diagrams below include:
Visitors access from a main circulation corridor with a relationship to the Main Entrance
Separate entry and access for inpatients, critical care units and Medical Imaging Unit
Access for service units such as Supply and Housekeeping via a service corridor
According to these guidelines, Medical Imaging may be located in the basement of facilities
providing such services.
1.4.2 Internal Relationships
Internally, the Medical Imaging Unit will be arranged in functional zones. The entrance to the unit
will provide access control with a Reception. Imaging and scanning areas will be located in clusters
along with related support facilities such as holding, sub-waiting areas and change rooms for
patients. Support areas such as reporting, and processing will be located conveniently to the
imaging areas and may be shared. Staff areas may be located in a discreet and staff only accessible
area.
The Medical Imaging Unit should have a clear one-way flow of patients from entry, holding,
imaging procedures, to recovery and then exit, for both ambulant and bed/trolley patients.
The optimum internal relationships demonstrated in the diagrams below include the following:
Reception at the entrance providing access control, with Waiting and amenities.
Imaging areas arranged into zones including general X-Ray, Fluoroscopy, CT Scanning,
Angiography and MRI
Patient areas including bed bays and Recovery centrally located convenient to Interventional and
Scanning Rooms for sharing between imaging modalities
Support areas located centrally to imaging rooms and adjacent to areas of need for staff and
patient convenience
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Network data requirements and wireless network requirements to support remote reporting
Video and teleconferencing capability, including connection to imaging rooms for educational
purposes
CCTV surveillance if indicated
Patient, staff, emergency call, duress alarms and paging systems
Communications rooms and server rooms
Reporting and recording systems that may include dictation or voice recognition and include printing
of reports
Staff Call
Patient, staff assist and emergency call facilities shall be provided in all patient areas (e.g. Holding
bays, Recovery bays, Preparation rooms, Change Rooms, Toilets and Imaging rooms) in order for
patients and staff to request for urgent assistance.
The individual call buttons shall alert to an annunciator system. Annunciator panels should be located
in strategic points visible from Staff Stations and audible in Staff Rooms and Meeting Rooms.
Heating, Ventilation and Air conditioning (HVAC)
The Medical Imaging Unit should be air-conditioned to provide a comfortable working environment
for staff and visitors. Interventional Imaging rooms may require air-conditioning equivalent to
operating room conditions, i.e. filtered and positive pressured. Rooms with heat generating
equipment may require special air-conditioning. Refer to Part E - Engineering Services in these
guidelines and to the Standard Components, RDS and RLS for further information.
Medical Gases
Medical gas is that which is intended for administration to a patient in anaesthesia, therapy, or
diagnosis.
The Unit requires oxygen and suction in all patient investigation rooms, treatment rooms and
procedure rooms and patient bays. The Provision of medical air to patient recovery bays and
interventional rooms is optional.
Full anaesthetic capability is required within interventional diagnostic rooms, including systems for
the delivery of nitrous oxide and the ‘scavenging’ of gases that have been exhaled by the patient that
should not be breathed in by any medical personnel.
Refer to Part E - Engineering Services in these guidelines and to the Standard Components, RDS and
RLS for further information.
Radiation Shielding
All rooms that are used for undertaking imaging procedures require radiation shielding. A certified
physicist or qualified expert needs to assess the plans and specifications for radiation protection as
required by National Centre for Radiation Protection (NCRP) at King Abdullah City for Atomic and
Renewable Energy (KACARE). A radiation protection assessment will specify the type, location and
amount of radiation protection required for an area according to the final equipment selections, the
layout of the space and the relationship between the space and other occupied areas.
The radiation protection requirements are to be incorporated into the final specifications and
building plans. Radiation requirements should be re-assessed if the intended use of a room changes
during the planning stages, equipment is upgraded, or surrounding room occupancy is altered.
Consideration should be given to the provision of floor and ceiling shielding when rooms immediately
above and below are occupied.
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along with the services required such as power, data and hydraulics; Fixtures and Equipment
are also identified with a group number as above indicating who is responsible for provision
• Building Services; indicates the requirement for communications, power, Heating,
Ventilation and Air conditioning (HVAC), medical gases, nurse/ emergency call and lighting
along with quantities and types where appropriate. Provision of all services items listed is
mandatory
The Room Layout Sheets (RLS’s) are indicative plan layouts and elevations illustrating an example of
good design. The RLS indicated are deemed to satisfy these Guidelines. Alternative layouts and
innovative planning shall be deemed to comply with these Guidelines provided that the following
criteria are met:
• Compliance with the text of these Guidelines
• Minimum floor areas as shown in the schedule of accommodation
• Clearances and accessibility around various objects shown or implied
• Inclusion of all mandatory items identified in the RDS
The Medical Imaging Unit contains Standard Components to comply with details in the Standard
Components described in these Guidelines. Refer to Standard Components Room Data Sheets and
Room Layout Sheets.
1.6.1 Non-Standard Rooms
Non-standard rooms are rooms are those which have not yet been standardised within these
guidelines. As such there are very few Non-standard rooms. These are identified in the Schedules of
Accommodation as NS and are separately covered below.
Orthopantomography (OPG) Room
The OPG imaging unit may be located in a room or bay. The room size is dependent on the equipment
to be installed; circulation space is required around the imaging unit. Access is required for patients
in wheelchairs.
• Room requirements include:
• Radiation shielding of the space with access to lead gowns for the patient and staff
• Radiation warning light
• Patient and emergency call system
• A handbasin in close proximity
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Office - Workstation off-ws-d 1 x 5.5 1 x 5.5 1 x 5.5 Transport Staff; locate adjacent to trolley parking
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ROOM/ SPACE Standard Component RDL 2 RDL 3 RDL 4 RDL 5 RDL 6 Remarks
2 2 2 2 2
Room Codes Qty x m Qty x m Qty x m Qty x m Qty x m
Play Area plap-10-d 1 X 10 1 x 10 1 x 10 Adjacent to Family waiting 4-5 places for children
Waiting wait-10-d similar 2 x 5* 2 x 5* 2 x 10 2 x 10 2 x 10 *Optional for level-2 & 3. Gender segregated areas
Screening Room (Fluoroscopy) scrn-d 1 x 30 2 x 30 2 x 30 4 x 30 Includes control; qty of rooms to suit service plan
Patient Bay - Holding pbtr-h-10-d 2 x 10 4 x 10 4 x 10 4 x 10 Gender segregated, may be located in recovery area
Bay - PPE bppe-d 1 x 1.5 1 x 1.5 1 x 1.5 1 x 1.5 2 x 1.5 For Lead Apron storage
Bay - Resuscitation Trolley bres-d 1 x 1.5 1 x 1.5 1 x 1.5 1 x 1.5 may be shared
Dirty Utility dtur-12-d similar 1 x 10 1 x 10 1 x 10 1 x 10 Disposal, clean-up, dirty linen storage; may be shared
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ROOM/ SPACE Standard Component RDL 2 RDL 3 RDL 4 RDL 5 RDL 6 Remarks
2 2 2 2 2
Room Codes Qty x m Qty x m Qty x m Qty x m Qty x m
CT Scanning - Reporting Room xrrr-d similar 1 x 9 1 x 9 1 x 9 One workstation/2 scanning rooms
Patient Bay - Holding, pbtr-h-10-d 2 x 10 2 x 10 2 x 10 1 for each scanning room. Gender segregated
Toilet –Patient wcpt-d 2 x 4 2 x 4 2 x 4 Gender segregated; may share with adjacent areas
Bay - Handwashing, Type B bhws-b-d 1 x 1 1 x 1 1 x 1 1 per 4 bed bays; Refer to Part D Infection Control
Bay - PPE bppe-d 1 x 1.5 1 x 1.5 2 x 1.5 For Lead Apron storage
Ultrasound ultr-d 1 x 14 2 x 14 3 x 14 4 x 14
Mammography mammo-d 1 x 14 1 x 14 1 x 14
Viewing and Reporting Room xrrr-d similar 1 x 12 1 x 12 1 x 12 1 12 Adjust size to suit service plan
Patient Bay - Holding pbtr-h-10-d Refer to Holding/Recovery Areas for patient bays
Bay - Handwashing, Type B bhws-b-d 1 x 1 1 x 1 1 x 1 1 x 1 1 per 4 bed bays; Refer to Part D Infection Control
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ROOM/ SPACE Standard Component RDL 2 RDL 3 RDL 4 RDL 5 RDL 6 Remarks
2 2 2 2 2
Room Codes Qty x m Qty x m Qty x m Qty x m Qty x m
X-Ray Viewing and Reporting xrrr-d 1 x 12 1 x 12 1 x 12 May be combined with Control room
Patient Bay - Holding pbtr-h-10-d 2 x 10 4 x 10 6 x 10 Refer to Holding/Recovery Areas for patient bays
Bay - Resuscitation Trolley bres-d 1 x 1.5 1 x 1.5 1 x 1.5 May be shared if located close to another trolley
MRI Computer Equipment Room, coeq-8-d 1 x 8 2 x 8 2 x 8 MRI. requirements as per manufacturers specs
Viewing and Reporting Room xrrr-d 1 x 12 1 x 12 1 x 12 May be combined with Control Room
Bay - Handwashing, Type B bhws-b-d 1 x 1 1 x 1 1 x 1 1 per 4 bed bays; Refer to Part D Infection Control
Bay - Handwashing, Type A bhws-a-d 1 x 1 2 x 1 2 x 1 1 per MRI room, in close proximity to MRI rooms
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ROOM/ SPACE Standard Component RDL 2 RDL 3 RDL 4 RDL 5 RDL 6 Remarks
2 2 2 2 2
Room Codes Qty x m Qty x m Qty x m Qty x m Qty x m
Bay - Resuscitation Trolley bres-d 1 x 1.5 1 x 1.5 1 x 1.5 Non-ferrous
Patient Holding/ Recovery Areas 4 bays 8 bays 12 bays Optional if centralised Holding/Recovery Area
Bay - Resuscitation Trolley bres-d 1 x 1.5 1 x 1.5 1 x 1.5 May be shared with imaging areas if close
Bay - Resuscitation Trolley bres-d 1 x 1.5 1 x 1.5 1 x 1.5 May be shared between imaging areas
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ROOM/ SPACE Standard Component RDL 2 RDL 3 RDL 4 RDL 5 RDL 6 Remarks
2 2 2 2 2
Room Codes Qty x m Qty x m Qty x m Qty x m Qty x m
Dirty Utility dtur-s-d similar dtur-12-d 1 x 8 1 x 10 1 x 12 Optional, Shared between imaging and patient areas
Preparation/ Set-up Room prep-s-d 1 x 9 1 x 9 1 x 9 1 x 9 For contrast media storage and preparation
Store - Photocopy/ Stationery stps-8-d 1 x 8 1 x 8 1 x 8 Printing/ Digitiser; may locate in work space
Office - Shared off-2p-d off-3p-d similar off-4p-d 1 x 12 1 x 16 1 x 20 2, 3 & 4 person shared areas
Office - Workstation off-ws-d 2 x 5.5 4 x 5.5 6 x 5.5 General imaging staff, PACs reporting, as required
Staff Room srm-15-d similar 1 x 15 1 x 20 1 x 20 May be divided into gender segregated areas
Change - Staff (Male/ Female), chst-12-d similar 2 x 14 2 x 14 2 x 14 Gender segregated; Includes shower/ toilets/ lockers
Circulation % 35 35 35 40 40
Area Total 96.5 373.2 1654.4 2401.7 3029.6 Including the centralised Holding/Recovery Area
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