This section is from the book "Modern Buildings, Their Planning, Construction And Equipment Vol3", by G. A. T. Middleton. Also available from Amazon: Modern Buildings.
One of these serves as a casualty and the other as a tradesman's entrance, and there are doors also leading from each into an internal area, which contains an iron fire-escape staircase as a secondary exit from the floor above in case of fire. On the casualty side there is direct communication from the entrance, either to the house surgeon's examination-room in one direction, or down the corridor to the main communication corridor which leads to the wards, passing a room devoted to special baths on the way, as well as the linen stores and mending-room belonging to the hospital, and the nurses' dining-room, which latter is placed close to the communicating corridor.
The other corridor through the administrative block serves the kitchens. The main kitchen is placed in the centre and is top lighted. It is shown on plan as a bare room, for the cooking would be done entirely by modern appliances without the use of a coal fire. From the kitchen, service, except to the staff dining-room, is made entirely through a hatch to a serving lobby, where the trolleys are loaded and passed forward. The servants' dining-room, like that of the nurses, is close to the communicating corridor, and at that end also are placed the pantries and crockery store, while the food stores are ranged in series on the farther side of the corridor from the kitchen, and are carefully departmented, there being separate stores for bread, for cooked meat, for fresh meat, and for grocery, while a sufficiently large room is also provided for cleaning knives and boots.
The perfection of the departmenting may well be noticed. Thus the kitchen has all kitchen requisites within reach, while perfect service is secured, whether it be to the wards or to the three separate dining-rooms for the medical staff, nurses, and servants. Similarly the linen stores, with the mending-room and the mattress store, are under the control of the nurses. One side is therefore devoted to kitchen use and the other to hospital use, with just sufficient intercommunication for service purposes.
Only the front portion is carried up above the ground floor, and that contains, on the first floor, a large and handsome board-room opposite the staircase, with matron's offices, bedroom, and sitting-room on one side, and similar rooms for the use of the surgeons on the other, each with lavatories and bathrooms properly disconnected. The upper floor is devoted to servants' and nurses' bedrooms. All this is served by a secondary staircase as well as by the main staircase, and this is placed so as to be under the immediate supervision of the matron.
The out-patients' department, illustrated in Fig. 16, is planned somewhat upon the same idea as in the administration block, considerable use being made of top lighting, as it is a single-storey building. Externally it is symmetrical, and internally also to a considerable extent; and it is planned round a centre hall much as the administrative block is planned round the kitchen. The entrance, through a porch and anteroom, leads directly into a large waiting-hall, though a house surgeon's receiving-room is so placed as to command the ante-room. From this hall the various consulting-rooms open, while there are retiring-rooms for men and women on either side, each with proper air disconnection. The exits are quite distinct, nobody passing back to the waiting-room after having once entered the consulting-room. External lighting as well as top lighting is given to the dental-room and the ophthalmic-room, but the ordinary consulting-rooms have top lights only, and there is a small dressing-room in connection with each. These all open to an external corridor, from which patients can pass either direct to the exit or to a covered way leading to the hospital; or else may find their way out through the medicine waiting-room, where they are able to line up, seated on long benches, until they are served through the pigeon holes from the dispensary. The back corridor is also used by the doctors in order to obtain access to the consulting-rooms.
Fig. 17 illustates one of the wards in detail, and although only the ground floor plan is shown, it is practically the same on the first floor. Turning at right angles off the main corridor, a well-lighted staircase is passed, with stores for coals, clothes, and brooms, and a couple of lifts. A square block is thus made up which is separated from the ward block proper by a short passage with folding glass doors on either side for purposes of disconnection. The same branch corridor (which turns to the right off the main corridor) is carried through to the ward, and is of sufficient width for carrying a patient along on a stretcher. In this way it passes a single-bed ward and the ward kitchen on one side, and a larder, linen airing room, and convalescents' dayroom on the other. The ward is a long building planned entirely in accordance with accepted ideas, the beds being ranged along either side, between windows which have high sills and arc carried up to the ceiling level, while they occur opposite to one another, so as to give a through current of air at all times. These long narrow windows are generally constructed as sashes for the greater part of their height, the upper portion being made as hoppers, opening inwards and shielded at the sides. These are kept almost always open, and are trusted much more for ventilation than any artificial system which may be used. The beds are spaced widely apart, and are placed so that it is possible to get round them on all sides. Wards are always at least 12 feet high, and, while anything above 13 feet is considered as waste space, it is often increased to 14 or even 15 feet for the sake of appearance. In this instance the width is 27 feet, but it is often as little as 22 feet, when, however, the length is proportionately increased so as to secure a sufficient cubical air space per patient. The allowance in general hospitals is usually about 1200 cubic feet per patient, but for wards devoted to infectious diseases this is frequently raised to as much as 2000 cubic feet. Where the patients are children, however, half of this is frequently considered to be sufficient. At Bedford the warming is effected by means of what are known as Manchester stoves, these being low stoves with table tops which stand in the middle of the ward and have open fires at both ends of them. Air is admitted to them from ducts which pass under the floor, and, passing round outside the casing of the fireplace, it enters the ward in a heated state, while the smoke and other products of combustion are likewise carried down to horizontal flues beneath the floor to chimneys in the outer wall. The necessary cleaning eye for sweeping purposes will be seen upon the plan.