Decision No. 1327/2002/QD-BYT on issuing technical standards for the design of regional multi-purpose health clinics

Pursuant to …;

Regarding the issuance of the design standards for district general outpatient clinics

standard industry sector

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THE MINISTER OF HEALTH

Pursuant to the Decree No. 68/CP dated October 11, 1993 of the Government on the functions, tasks, powers, and organizational structure of the Ministry of Health;

Based on the need for designing district general outpatient clinics to standardize the construction of medical facilities, in line with societal development;

At the proposal of the Director of the Equipment and Medical Construction Department,

DECISION:

Article 1. Now hereby promulgates "Design Standards for District General Outpatient Clinics"

Article 2. Directors of Health Departments of provinces and centrally governed cities shall base these design standards for district general outpatient clinics when constructing new clinics or renovating old ones that have deteriorated and no longer meet operational requirements.

Article 3. This Decision takes effect from the date of issuance. All previous regulations contrary to these standards are abolished.

Article 4. The Heads of the Office, Directors of relevant Departments under the Ministry of Health such as the Equipment and Medical Construction Department, Planning Department, Treatment Department, Traditional Medicine Department, Maternal and Child Health Care and Family Planning Department, and other related Departments; and Directors of Health Departments of provinces and centrally governed cities are responsible for implementing this Decision./.

DISTRICT GENERAL OUTPATIENT CLINIC

DESIGN STANDARDS

1. Scope of Application.

These standards specify basic requirements for project investment planning, new construction design, and renovation design of district general outpatient clinics across the country.

2. Referenced standards and legal basis.

2.1. Vietnamese Standard TCVN 2748 - 1991 on classification of construction projects - General principles.

2.2. Government Decree No. 01/1998/NĐ-CP dated January 3, 1998 on the organizational structure of local health services.

2.3. Joint Circular No. 02/198/TTLT-BYT-BTCCBCP dated June 27, 1998 guiding the implementation of Decree No. 01/1998/NĐ-CP.

2.4. Decision No. 2967/QĐ-BYT dated June 29, 2001 approving the design tasks for district general outpatient clinics.

3. General provisions.

3.1. District General Outpatient Clinic (DGOC): A place where initial healthcare activities are carried out, providing services such as disease prevention, diagnosis and treatment, outpatient care, and treatment of common diseases and some specialties.

3.2. DGOCs are organized in inter-district areas far from county central hospitals; in counties previously merged; and in highland, remote, and island areas.

3.3 DGOC includes spaces for performing the following specialized tasks:

a) Providing basic first aid, emergency care, and support for transferring patients to higher-level facilities. Assigning staff to provide on-site emergency care when required.

b) Conducting diagnosis and treatment, dispensing medication, and outpatient care for common diseases, dental, ear-nose-throat, and eye specialties.

c) Managing pregnant women, delivering babies, caring for newborns, and providing family planning services according to treatment levels.

d) Temporarily housing patients requiring observation and critically ill patients awaiting transfer to higher-level facilities.

e) Managing the health of specified groups and treating chronic, social, and occupational diseases according to higher-level assignments.

f) Directly participating in community health work: educating about health care, reproductive health counseling, immunization, nutrition, and essential medicines.

g) Supervising subordinate primary health centers in disease prevention, public health, epidemiological surveillance, and training primary health workers.

3.4. DGOCs are defined by two scales of service:

- Small scale: from 80 to less than 120 outpatient visits/day with 6 to 10 beds.

- Large scale: from 120 to 150 outpatient visits/day with 11 to 15 beds.

Note: In cases where the DGOC is located on the same land as the primary health center, the number of beds does not include those already available at the primary health center.

3.5. DGOCs must be designed and constructed to meet Class II building standards, consistent with TCVN 2748 - 91. Renovations of existing buildings must also be reinforced and upgraded to meet Class II standards.

Note: - Areas prone to typhoons or floods should pay special attention to storm and flood protection measures.

- For highland, remote, and island areas, local materials should be used based on actual conditions.

4. Requirements for construction land.

The construction land must meet the following requirements:

4.1. The location of the DGOC construction land must be near inter-district or inter-county roads, convenient for residents to access healthcare services.

Note: The DGOC can be located on the same land as the primary health center without changing its function.

4.3. The construction land for the DGOC must have good environmental hygiene conditions, simple foundation solutions, and low construction costs.

4.4. The construction land for the DGOC must have a reliable supply of clean water.

5. Requirements for overall site layout.

5.1. The area of the construction land for the DGOC must be between 1,800 to 2,400 square meters, sufficient to accommodate the following components:

a) Main building including outpatient diagnosis and treatment, patient accommodation, administrative, and logistical sections.

b) Infrastructure: electricity, water supply, waste collection and treatment, sewage disposal.

c) Internal roads and gates, fences.

d) Courtyard, greenery (ornamental trees and shade trees).

e) Medicinal herb garden.

5.2. The proportion of construction land area should be between 30 to 35% of the total land area.

Note: The minimum distance from the outer edge of the main gate fence to the front of the building is 6 meters.

5.3. The proportion of green space area (including shaded trees, flower gardens, and medicinal herb gardens) should be between 30 to 40% of the total land area.

Note: Do not plant toxic, spiky, or fruit-bearing trees that attract flies and insects.

5.4. Within the DGOC premises, waiting areas, parking lots for visitors and staff, ambulance garages, and internal roads with a minimum width of 2 meters must be arranged.

5.5. The DGOC must have gates and fences for separation and security.

6. Requirements for design solutions of construction components.

6.1. General requirements

6.1.1. The spatial organization solution of the DGOC must meet the following requirements:

a) Comply with functional requirements, without overlapping activities among medical examination - treatment, primary health care, preventive healthcare, and epidemiological hygiene tasks.

b) The workflow must follow a unidirectional principle, ensuring separate clean and dirty areas.

c) Examination rooms, treatment rooms, delivery rooms, and family planning services must be arranged separately to ensure sterile conditions.

d) Construction items must be compatible with medical equipment listed in the Medical Equipment Catalog (as per Decision No. 437/QĐ-BYT dated February 20, 2002).

6.1.2. Room Height.

a) Rooms in the main building must have a minimum height of 3.3 meters.

b) Ancillary rooms and bathrooms must have a minimum height of 2.8 meters.

6.1.3. Hallway Width.

a) Side hallways (combined with waiting areas) must be at least 2.4 to 2.8 meters wide.

b) Side hallways (without waiting areas) must be at least 1.5 to 1.8 meters wide.

Note: The hallway should have a roof to protect from rain and sun.

6.1.4. Door Dimensions.

a) The minimum height for all types of doors must be 2.1 meters.

b) Standard doors must have a minimum width of 1.4 meters.

c) Doors for stretcher and litter transport must have a minimum width of 1.4 meters.

d) Delivery room doors must have a minimum width of 1.4 meters.

e) Bathroom doors must have a minimum width of 0.7 meters.

6.1.5. Staircase.

a) The maximum slope of staircases must be 30 degrees.

b) Each staircase tread must have a minimum width of 1.5 meters.

c) Landing widths must be at least 1.5 meters.

d) Main staircases must have ramps for stroller access.

6.2. Requirements for Construction Items.

Table 1.

Ultrasound

9m2 (one ultrasound machine room)

18m2 (two ultrasound machine rooms)

Family Planning Services

14m2 (one procedure table)

Minimum area 14m2 per procedure table for family planning services

Postpartum Women

15m2 (2 beds)

Minimum area. Includes postpartum room and adjacent bathroom (3 to 4 m2)

Note: - Patient room area from 6-8m2 per bed

- If possible, patient rooms should have an adjacent bathroom.

6.2.5. Auxiliary Area.

The area of auxiliary rooms, hallways, and pathways within the building is specified in Table 5.

Table 5.

7. Technical Solutions Requirements.

7.1. Lighting and Ventilation.

7.1.1. In the community health center, rooms must be naturally lit and ventilated directly.

Note: Except for the X-ray room, which must be artificially lit and ventilated.

7.1.2. The window area for natural lighting in rooms is specified in Table 6.

Table 6.

7.2. Infrastructure Technology.

7.2.1. Power Supply

a) The community health center must be equipped with a synchronized power supply system to provide lighting in rooms and operate technical equipment.

b) The community health center must have uninterrupted 24-hour power supply, with backup power sources (generator or small hydroelectric generator for mountainous areas near rivers or streams).

c) The power supply system must use insulated copper wire, installed either exposed or embedded in walls and ceilings, with automatic switches in each room to ensure safety.

7.2.2. Water Supply

a) The community health center must have continuous 24-hour clean water supply from municipal water, wells, or treated water reservoirs meeting the Ministry of Health's water quality standards as per Decision No. 505/BYT-QĐ.

b) The daily water consumption for a community health center ranges from 25 to 30 cubic meters.

c) The community health center must have a potable water tank and fire protection reserve tank with a capacity of 25 to 30 cubic meters; additionally, there must be rooftop water tanks and water tanks in bathrooms.

7.2.3. Drainage

The community health center must have an on-site drainage system using gravity flow combined with sewers, without affecting the environment.

7.2.4. Wastewater Treatment

a) The community health center must have a wastewater treatment system.

b) Wastewater from the examination and treatment area and bathrooms must be collected and treated separately to ensure environmental hygiene.

c) Emergency rooms, minor surgery rooms, delivery rooms, and family planning services must have a wastewater collection system for cleaning purposes.

7.2.5. Solid waste.

The health care facility must have a separate area to collect solid waste, equipped with processing facilities, and a decomposition pit at least 20 meters away from the main building, without affecting the surrounding environment.

7.3. Fire prevention and firefighting requirements.

7.3.1. The health care facility must be a fire-resistant structure of Class III (according to TCVN 2748 - 1991).

7.3.2. The health care facility must have an indoor fire extinguisher foam system.

7.3.3. Within the construction site, there must be a water reservoir or well, and a sand pit for firefighting purposes placed near the main building.

7.4. Requirements for structural design and completion of the project.

7.4.1. Walls.

a) Interior and exterior walls must be painted or whitewashed.

b) Walls inside examination and treatment rooms, patient wards, drug storage areas, sterilization and drying equipment rooms, and bathrooms must be tiled with glazed ceramic tiles or painted with waterproof paint up to a height of 1.8 meters. The remaining parts of the wall can be painted or whitewashed with light colors.

Note: The walls in the room housing X-ray machines must be plastered with radiation-proof mortar (barium mortar) and must be certified safe for radiation protection before use.

7.4.2. Floors.

Floors must be laid with ceramic tiles or cement flower tiles, polished granite, ensuring non-slip surfaces and ease of cleaning.

7.4.3. Ceilings.

a) Ceilings may be designed flat or sloped, ensuring hygiene, thermal insulation, moisture resistance, and waterproofing requirements.

Note: For structures using a second floor, the ceiling in the room housing X-ray machines must be plastered with radiation-proof mortar (barium mortar).

b) Ceilings must be painted or whitewashed with light colors.

7.4.4. Windows.

a) Windows must have frames, protective grilles, and insect screens.

b) Window panels must be made of wood, aluminum, steel, or combined with louvers and clear glass for ventilation, natural lighting, and wind protection.

Note: For windows opening onto corridors or passageways of emergency rooms, minor surgery rooms, delivery rooms, family planning services, and patient wards, frosted glass must be used to prevent visibility into the rooms.

7.4.5. Doors.

a) Doors must have frames that ensure durability and safety.

b) Door panels must be made of wood, aluminum, steel, or combined with louvers and glass.

Note: Doors leading to emergency rooms, minor surgery rooms, delivery rooms, family planning services, and gynecological examination rooms must be discreet (solid panels or combined with frosted glass).

c) Doors to rooms housing X-ray machines must meet radiation safety requirements and have warning lights. Panels must be made of lead or other radiation-blocking materials (lead, rubber, lead compounds, etc.).

7.4.6. Structural design and completion of the project.

a) Components of the health care facility must have durable structures, easy to construct and install, suitable for local construction conditions.

b) Components of the health care facility must be built and renovated to complete both interior and exterior finishes according to current construction standards and specific requirements for medical facilities.

7.4.7. Architectural style.

a) The health care facility must have a modern architectural style suitable for its nature as a medical facility.

b) As the health care facility is mainly located in remote, mountainous, and deep rural areas, the architectural style must be compatible with traditional architectural elements of the locality, harmonizing with the landscape and overall planning.