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Building Design



Comparison of Dedicated and Swing
Public/Service Elevators in Hospitals
by Samson Rajan Babu
photos courtesy of Hydraulik–Liftsysteme Walter Mayer GmbH, InterMetro, Cambro,
Schindler, Lobby Solutions, Swisslog, Construction Specialties and Dural GmbH




                                                         Introduction                              N Access security controls
                                                            This article investigates the chal-    N Key controls
                                                         lenges of swing public/service eleva-     N Serves all floors, including base-
                                                         tors and the factors to consider while      ments and mechanical floors
                                                         providing a dedicated service eleva-      Typical Arrangements
                                                         tor. In a modern hospital project,             A service elevator can be provided
                                                         architects recommend a variety of         in   several arrangements, such as:
                                                         elevator types: public elevators, bed     N    Dedicated service elevator: The ser-
                                                         service elevators, staff elevators,            vice elevator is located away from
                                                         general-purpose goods elevators,               the public elevators and has its
                                                         dumbwaiters, and both sterile and              own service approach lobby and
                                                         soiled theater elevators. Architects           staging areas. The elevator core
                                                         typically wish to reduce the number            shape corresponds to deeper car
                                                         of elevator cores to the minimum               types for the transport of stretch-
                                                         possible in order to gain more usable          ers, carts, etc.
                                                         space. There is often a tendency to       N    Swing public/service elevator –
                                                         double the role of public elevators to         common public lobby: The service
                                                         move materials, supplies and service/          elevator is among the public ele-
                                                         support personnel. It is also common           vator group, and the main lobby is
                                                         for public elevators to be used to             also used as a service lobby and
                                                         transport patients confined to beds            staging area. The elevator core
                                                         and wheelchairs.                               shape could be for a standard,
                                                         Description                                    wider passenger elevator car. This
                                                            A service (or “bed service”) eleva-         shape cannot accommodate stretch-
                                                         tor allows the vertical transportation         ers. Alternatively, the service ele-
Samson Rajan Babu is a                                   of materials, supplies and miscella-           vator core shape could be for the
senior vertical transporta-                              neous goods. It also helps segregate           deeper car type, with the remain-
tion engineer for Burt Hill,                                                                            ing public elevators for the wider
                                                         movement of tradespeople, service
a Stantec Co. He offers
                                                         and maintenance personnel on duty.             car type. This results in a staggered
expert elevator traffic anal-
                                                         In a hospital, it could also be used to        elevator core shape that could
ysis, group planning, vertical-
transportation system de-
                                                         transport non-ambulatory patients              negatively affect the surrounding
sign, specification writing,                             confined to beds, wheelchairs and              rentable area.
tender management, post-                                 stretchers.                               N    In rare cases, the entire public ele-
contract construction management and project             Typical Features                               vator group and service elevator
execution quality control for elevator and escala-       N Large payload                                are arranged in the deeper car type
tor systems. Babu is also responsible for inter-         N Deeper car (to accommodate bed-              to achieve a uniformly shaped
facing with other trades. He has 11 years’ working         /stretcher-shaped items)                     elevator core. While a deeper car
experience in elevator/escalator group design,           N Side-opening telescopic doors                serves well for service traffic, it is
specification development, post contract, project
                                                         N Simple and sturdy cab finishes and           not a preferred arrangement for
management, installation management, and project
                                                           flooring                                     passenger traffic. Deeper car types
sales of elevators and escalators.
                                                         N Crash rails                                  cause longer passenger transfer
                                                                                                                                        Continued

52   | WWW.ELEVATORWORLD.COM | March 2011
Building Design                          Continued




  times at each stop, affecting round-trip time. In addi-         Hospital Traffic Movement
  tion, the passengers stand as in a queue inside the                In a hospital, there is a wide range of materials, equip-
  deeper car, which is an undesirable feeling.                    ment and supplies that need to be transported to various
N Swing public/service elevator – rear service lobby: The         floors through the service elevators (Figure 1). Operatives
  service elevator is among the public elevator group but         and service personnel also require service elevators to
  has a through-type car with two car entrances at 90º.           commute to upper floors. Materials and supplies are
  The front entrance is used for passenger traffic, while         different types that cannot be mixed but need dedicated
  the rear entrance is used for service traffic.                  trips. Items such as hot food require rapid distribution.
Typical Control Systems                                           Material movement within a hospital can be affected
N Independent control mode: Service elevators are usu-            by manually operated carts and trolleys or automated
  ally provided with independent key controls and card            guided vehicles.
  readers to take command of the elevator for service                Typically, the following types of service/personnel move-
  use. This is the ideal operation mode for service eleva-        ments are observed within a hospital:
  tors, with which the service traffic is handled separate        N Patient beds and wheelchairs
  from the public traffic.                                        N Linen carts
N Rear-entrance operation mode: Service elevators adja-           N Meal carts
  cent to public elevators and/or part of public elevator         N Hot food distribution
  groups are provided with “group separation operation”           N Nourishment distribution
  controls and a dedicated set of car operating-panel             N Housekeeping, stationery and administrative equipment
  and hall-call stations, and indicators for rear-entrance           supply trolley
  operation. Using a “group separation control,” the pub-         N Scan/portable medical equipment movement
  lic elevator is removed from the group and becomes a            N Pharmacy/clinical supply trolley
  single service elevator. It then operates exclusively           N Waste collection (medical and nonmedical) trolley
  based on commands from the rear-entrance controls.              N Sterile items supply trolley                         Continued




                       (a) Patient beds                (b) Housekeeping trolleys                     (c) Meal delivery carts




                 (d) Dirty linen carts                  (e) Clean linen carts                  (f) Automated guided vehicles
Figure 1: Types of service traffic within a hospital


54    | WWW.ELEVATOR-WORLD.COM | March 2011
Building Design               Continued




N Janitor, maintenance and support staff movement with           a specific predetermined route to approach and exit the
   tools and trolleys                                            service elevator. This route is typically laid away from the
   In addition to the general service traffic, non-ambulatory    main circulation routes and calls for more time spent to
patients’ movement is also necessary to move patients to         reach a destination, which is often directly above the origin.
treatment/scan areas and operation theaters. Here, two               Additional costs: A dedicated service elevator adds to
to three attendants accompany a patient. Depending on            the project’s investment, operating and maintenance costs.
the number of beds, transport cart sizes, dimensions and         It also mandates additional expenses on the structural
volume of materials and various other operational factors,       elevator core; mechanical, electrical and plumbing service;
the required number of elevator trips must be calculated,        fire and life-safety equipment; communication systems; and
and the total duration of elevator usage for hospital traffic    building-management equipment.
movement must be calculated.                                     Swing Public/Service Elevators
Dedicated Service Elevator                                       Concerns
Advantages                                                         Some concerns of healthcare planners about swing
   Improved traffic flow: In large hospitals with a consid-      public/service elevators include the following:
erable number of upper floors and high occupancy rates,          N Public traffic into sanitized service zones: There is no
the service traffic is high. By segregating and diverting          control of visitor movement, and visitors could penetrate
the service traffic to the dedicated service elevator, the         other hospital zones. These are usually kept sanitized
public elevators’ performance is unaffected with regard            and are prone to contamination from visitor traffic.
to waiting times and trip times, especially during peak          N Cross infection between patients and visitors: Patients
hours. Also, public lobbies are clear of obstructions,             sick with communicable diseases can infect unsuspect-
enabling faster public passenger transfers in and out of           ing visitors. Similarly, visitors with or who recently had
elevator cars. Apart from everyday traffic, damage and             communicable diseases can transfer germs to newborns
repair is restricted only to the dedicated service elevator,       and patients with weak immune systems.
and “time lost in repair” does not affect the performance        N Unpleasant experience and breach of privacy: For vis-
of the public elevator group.                                      itors, looking at patients on wheelchairs/stretchers
   Improved hygienic conditions: Patients within a hospi-          could be an unpleasant experience. Similarly, a patient’s
tal have weak immune systems and are thus prone to                 privacy is breached when unknown visitors see the
infections. By using exclusive bed service elevators for           patient, possibly causing embarrassment to the patient.
patient movement, infectious germs and contaminating             N Tidiness and hygienic environment: General service
agents brought in by the visitors are restrained from              traffic (materials, food, supplies, etc.) brings in debris,
spreading to the patients. Also, any undesirable personal          dirt, odor, spillover and stains. When not cleaned and
hygiene practices of service elevator users is limited to          sanitized properly, these can cause mold and fungi
the service elevator. Finally, improper disinfection and           buildup inside the elevator car. Thus, a healthy envi-
sanitizing of car interiors, and dirt, mold and fungi buildup      ronment cannot be guaranteed within general service
and odor inside a service elevator could otherwise affect          elevator cars at all times.
a sick patient.                                                  N Injuries and health risks: General service traffic could
   Contact/droplet/airborne germs are generally present            leave behind sharp objects, fluid leaks and radioactive
in a common/public service elevator, as it carries sick            objects inside the public car. Sharp objects could cause
patients. Such germs can infect visitors when they touch           injuries to visitors and cause further infection. Haz-
contaminated surfaces and objects (such as handrails or            ardous healthcare waste could leave behind traces of
push buttons). By using a dedicated bed service elevator,          infectious agents and spread to visitors, causing fur-
visitors are protected against such infections. This also pro-     ther infections.
tects visitors against hazardous wastes and sharp objects.         Other concerns about these elevators are:
Disadvantages                                                    N Service elevators have larger capacities when com-
    Larger floor plate: Depending on the preferred service         pared to public elevators. However, a service elevator
elevator’s location within the plot limit, the floor plate         is allowed to operate at a lower speed than public ele-
may need to be increased in order to accommodate the               vators, only needing to travel between the terminal
service elevator cores, lobbies and staging area. A large          floors within 60 seconds. However, when part of a
service lobby and staging area must be provided to match           public elevator group, the “upgraded service elevator”
the various turning radii of items moved. Rentable space           cannot be slower, but must operate at a high speed in
is lost to the dedicated service elevator.                         order to satisfy the criterion of travel time between
    Restrictions on material and service personnel flow:           destination floors. (The public elevators in a hospital
With a dedicated service elevator, the operatives should use       must travel between the terminal floors within 24 sec-

56   | WWW.ELEVATOR-WORLD.COM | March 2011
onds.) In effect, this combination increases the initial                           elevator is part of a public elevator group, then any fire
    equipment cost.                                                                    at the public elevator area will shut down the eleva-
N   Housekeeping, service and maintenance operatives                                   tors, including the service/firefighter’s elevator. This
    (with their tools and carts) must share the same lobby                             will deprive the firefighters of an effective means of
    as the visitors do. Visitors find it difficult to move in                          vertical transportation for firefighting and rescuing.
    and out of the lobby, and this increases passenger                              Advantages
    transfer times. This also results in an untidy lobby.                           N Cost savings: Initial investment cost is reduced, and cost
N   Depending on the codes followed for a specific project,                           savings are made by eliminating an additional service
    there could be a risk of overloading the swing service/                           elevator and the related elevator infrastructure equipment.
    public elevator car beyond the machinery capacity. For                            Running costs pertaining to operating and maintaining
    example, Japanese elevator codes (Figure 2) allow 3.75                            an additional service elevator are also eliminated.
    m2 for a 1000-kg capacity bed elevator. When used by                            N More rentable space: By doubling the usage of a public
    the public, the same elevator (due to its larger car area)                        elevator as a service elevator, valuable rentable space
    could be overloaded up to 80%. This could lead to a                               is freed on all floors.
    very unsafe situation.                                                          Disadvantages
N   Service elevators are required to handle large beds,                            N Cab interiors and entrance architraves of a public ele-
    furniture, etc. For this purpose, the entrance door size                          vator could be invariably damaged (even with the use
    (width and height) of a service elevator is quite differ-                         of protection pads) when used as a service elevator.
    ent from that of public elevators. Hence, a service                             N When damaged, repair takes time and requires shut-
    elevator’s entrance door stands out in a public eleva-                            down of the public elevator. Until repaired, it presents
    tor lobby due to its unusually large size, (Figure 3).                            an inferior look to the public.
    Increasing the entrance size of a public elevator to                            N Odor, dirt, trash and stains are usually left behind after
    match that of a service elevator would only lead to                               service use.                                        Continued
    unnecessary equipment costs.
N   Since service elevators handle large beds and other                                                                                 Car size (1800)

    furniture, their lobbies must be spacious in order to
    accommodate the turning radii with a sufficient working
                                                                                                                                  Handrail
    clearance (Figure 4). When the service elevator is part




                                                                                                                                                                         Approximately 2440 with pump
    of a public elevator group, the lobby needs to be much




                                                                                                                                                                            attached to end of bed
                                                                                                         Clear car size (2700)




    wider and deeper when compared to a public-only                                                                                  450           1000-1080

    lobby width and depth. More rentable space is lost,                                                                            Trolley/




                                                                                                                                                                  2370
                                                                                                                                   equipment
    which is loss of revenue.
                                                                                                                                  600 (500)
N   It is always preferred to double the role of a service
    elevator as a firefighter’s elevator. When there is a
    dedicated service/firefighter’s elevator (away from the
    public elevator group), it results in “redundancy by
    location,” as any fire in the public elevator area will not
    affect the service/firefighter’s elevator. However, if this
                                                                                                                                                 1370

Car size,         Rated capacity         Equ. rated capacity Actual capacity as
area as per JEA   as per JEA             as per EN 81-1         per CIBSE Guide D
1500 mm x 2500 mm
                  1000 kgs. (13 persons) 1830 kgs. (24 persons) 19 persons
3.75 sq. mtrs.
                                                                                                                                                                                                                 Width of space for attendants




Figure 2: Comparison of car areas according to Japanese and European codes
                                                                                                                                                                                                                   to turn bed 180 degrees
                                                                                                                                                                                                        (3370)




                                                                                                                                              4310 (3980)
                                                                                                                                 Length of space for attendants
(a) Passenger elevator     (b) Passenger elevator        (c) Service elevator                                                       to turn bed 180 degrees

Figure 3: The larger entrance of a service elevator in a public elevator lobby      Figure 4: Extra lobby width is required to accommodate the turning radius of
presents an odd look.                                                               a large, motorized bed.


                                                                                                                                     March 2011 | ELEVATOR WORLD |                                                57
Building Design               Continued




N Negative effects on the originally planned handling          N Use heavy-duty floor tiles with good tile grip or check-
  capacity and waiting time of the public elevator group.        ered plate flooring within the elevator car.
N Under certain conditions (such as defective controls or      N Use coved-end flooring to facilitate easy cleaning
  a lost key), the service operatives may end up using the       (Figure 5).
  first available elevator in the public group for service     N Use easy-to-clean, smooth stainless-steel finishes for
  traffic. All the elevators in a public elevator group will     cabin interiors.
  then be exposed to these disadvantages.                      N Verify elevator interface requirements with automated
Design Considerations                                            guided vehicles.
Dedicated Service Elevator                                     N Allow for bumper/crash rails inside the car on all three
   If planning a dedicated service elevator or bed service       sides.
elevator, the following should be considered:                  N Allow for kick plates at the bottom level of the car to
N Based on number of floors and beds, and operational            absorb tire impacts.
   factors, estimate the required quantity and intensity of    Swing Public/Service Elevators
   bed, wheelchair, trolley and cart movements, and              If planning a swing public/service (or a swing
   other maintenance/service personnel movements.              public/bed service) elevator, the following should be
N Estimate the “running elevator hours” consumed exclu-        considered:
   sively for bed/material movement. Justify the require-      N Estimate the required quantity and intensity of move-
   ment for a dedicated service elevator.                        ments and “running elevator hours” as described above.
N Estimate car floor size, car clear height according to         If this figure is large, do not use a swing public/service
   desired cart/trolley sizes and their quantity per trip,       elevator.
   and the size of the largest equipment moved through         N Schedule the service trip timing so as not to clash with
   the elevator.                                                 peak-hour public traffic.
N Estimate payload capacity according to the desired cart/     N Avoid hot food distribution, which can create intense
   trolley loads per trip and the weight of the largest          traffic within a short duration (usually within 20 min-
   equipment moved through the elevator.                         utes). Instead, allow for devices at each floor to reheat
N Allow for a service entrance lobby with suitably sized         the food.
   staging and operating space. The lobby must be self-        N For nonperishable items (such as linen and adminis-
   contained without extending into other functional space.      trative supplies), provide storage shelves at upper floors
N Allow for sufficient lobby width for the turning radius        and replenish stock during off-peak hours.
   of the equipment with the longest dimensions.               N Do not also use the public entrance lobby for service
N Estimate door clear width and height according to the          traffic. Always provide dedicated rear service entrance
   largest equipment dimensional requirements.                   and a rear service lobby.
N Locate the service elevator core away from public ele-       N Use special operating modes, communication devices,
   vators to increase the redundancy level during fire           delay alarms and visual indicators, forcing operators to
   emergencies.                                                  use the swing public/service elevator sensibly and to
N Verify the availability and connecting lobby to the alter-     return the elevator to public service promptly.
   nate service elevator should the main one fail.
N Avoid dirt-catching, hard-to-clean crevices, recesses and
   joints inside the car.




Figure 5: Coved-end flooring                                   Figure 6: Card reader control inside elevator car


58   | WWW.ELEVATOR-WORLD.COM | March 2011
N Devise suitable operational procedures (forms) to con-                         N Maintain schedules for regular cleaning and sanitizing
  trol and authorize the use of a public elevator as a                             service elevator cars. Conduct regular audits on schedule
  service elevator (Figure 6).                                                     compliance and surprise checks on the car interiors.
N Allow for crash rails and permanent hooks at the top level                     Conclusion
  of the car for removable car protection pads (Figure 7).                          A hospital is a space for the sick to recuperate, and it
Operation and Maintenance Considerations                                         should provide a comfortable healing experience for pa-
  In both dedicated and swing service elevators, imple-                          tients and chaperones. For visitors, a hospital is also a space
menting the following operational procedures can help                            that should be hygienic. For healthcare professionals, a hos-
organize the service traffic evenly and improve public                           pital should also be functional, and easy to use and maintain.
health and hygienic conditions within a hospital:                                   A hospital operator cannot afford any shortcoming on
N Devise and implement material/service personnel move-                          patient comfort, hygiene or public health. This could be
  ment policies and monitor compliance. Address issues                           detrimental to the business aspirations of the hospital.
  such as authorized usage and approved timelines for                            Expert selection and arrangement of transportation and
  service elevator usage, and record the duration of serv-                       circulation elements are extremely essential in order to
  ice elevator usage.                                                            maintain high levels of patient comfort, patient privacy
N Include access security (card readers, passwords and                           and public health. As consumer demand and awareness
  keys) for gaining exclusive command of elevator car                            for services and quality of services increase, it is the
  (Figure 6).                                                                    author’s understanding that a dedicated service elevator
N Include floor access security for sterile floors, burns-                       will soon become the norm of the healthcare industry.
                                                                                 References
  unit floors, etc.                                                              [1] AIA Guidelines For Design And Construction Of Health Care Facilities: 2006.
N Always use fully covered trolleys and carts, and soak-                         [2] Health Technical Memorandum 08-02: Lifts: 2010.
                                                                                 [3] CIBSE Guide D: Transportation Systems in Buildings: 2005.
  free disposal bags to transport loose or sharp objects.                        [4] Japanese Industrial Standard A 4301:1983: Sizes of car and hoist way of
  Handle odor and stains securely and discreetly.                                    elevators.




                                                                                                        (b) Car protection pad




                                                                                                     (c) Entrance protection pads




                 (a) Car with complete accessories: kick plate, handrail and crash rails
                                                                                                     (d) Crash rail with handrail
Figure 7: Elevator car and entrance protection


                                                                                                                  March 2011 | ELEVATOR WORLD |             59

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VTME dubai Rajan Samson Article on Comparison of dedicated against common service elevators in hospitals

  • 1. Building Design Comparison of Dedicated and Swing Public/Service Elevators in Hospitals by Samson Rajan Babu photos courtesy of Hydraulik–Liftsysteme Walter Mayer GmbH, InterMetro, Cambro, Schindler, Lobby Solutions, Swisslog, Construction Specialties and Dural GmbH Introduction N Access security controls This article investigates the chal- N Key controls lenges of swing public/service eleva- N Serves all floors, including base- tors and the factors to consider while ments and mechanical floors providing a dedicated service eleva- Typical Arrangements tor. In a modern hospital project, A service elevator can be provided architects recommend a variety of in several arrangements, such as: elevator types: public elevators, bed N Dedicated service elevator: The ser- service elevators, staff elevators, vice elevator is located away from general-purpose goods elevators, the public elevators and has its dumbwaiters, and both sterile and own service approach lobby and soiled theater elevators. Architects staging areas. The elevator core typically wish to reduce the number shape corresponds to deeper car of elevator cores to the minimum types for the transport of stretch- possible in order to gain more usable ers, carts, etc. space. There is often a tendency to N Swing public/service elevator – double the role of public elevators to common public lobby: The service move materials, supplies and service/ elevator is among the public ele- support personnel. It is also common vator group, and the main lobby is for public elevators to be used to also used as a service lobby and transport patients confined to beds staging area. The elevator core and wheelchairs. shape could be for a standard, Description wider passenger elevator car. This A service (or “bed service”) eleva- shape cannot accommodate stretch- tor allows the vertical transportation ers. Alternatively, the service ele- Samson Rajan Babu is a of materials, supplies and miscella- vator core shape could be for the senior vertical transporta- neous goods. It also helps segregate deeper car type, with the remain- tion engineer for Burt Hill, ing public elevators for the wider movement of tradespeople, service a Stantec Co. He offers and maintenance personnel on duty. car type. This results in a staggered expert elevator traffic anal- In a hospital, it could also be used to elevator core shape that could ysis, group planning, vertical- transportation system de- transport non-ambulatory patients negatively affect the surrounding sign, specification writing, confined to beds, wheelchairs and rentable area. tender management, post- stretchers. N In rare cases, the entire public ele- contract construction management and project Typical Features vator group and service elevator execution quality control for elevator and escala- N Large payload are arranged in the deeper car type tor systems. Babu is also responsible for inter- N Deeper car (to accommodate bed- to achieve a uniformly shaped facing with other trades. He has 11 years’ working /stretcher-shaped items) elevator core. While a deeper car experience in elevator/escalator group design, N Side-opening telescopic doors serves well for service traffic, it is specification development, post contract, project N Simple and sturdy cab finishes and not a preferred arrangement for management, installation management, and project flooring passenger traffic. Deeper car types sales of elevators and escalators. N Crash rails cause longer passenger transfer Continued 52 | WWW.ELEVATORWORLD.COM | March 2011
  • 2. Building Design Continued times at each stop, affecting round-trip time. In addi- Hospital Traffic Movement tion, the passengers stand as in a queue inside the In a hospital, there is a wide range of materials, equip- deeper car, which is an undesirable feeling. ment and supplies that need to be transported to various N Swing public/service elevator – rear service lobby: The floors through the service elevators (Figure 1). Operatives service elevator is among the public elevator group but and service personnel also require service elevators to has a through-type car with two car entrances at 90º. commute to upper floors. Materials and supplies are The front entrance is used for passenger traffic, while different types that cannot be mixed but need dedicated the rear entrance is used for service traffic. trips. Items such as hot food require rapid distribution. Typical Control Systems Material movement within a hospital can be affected N Independent control mode: Service elevators are usu- by manually operated carts and trolleys or automated ally provided with independent key controls and card guided vehicles. readers to take command of the elevator for service Typically, the following types of service/personnel move- use. This is the ideal operation mode for service eleva- ments are observed within a hospital: tors, with which the service traffic is handled separate N Patient beds and wheelchairs from the public traffic. N Linen carts N Rear-entrance operation mode: Service elevators adja- N Meal carts cent to public elevators and/or part of public elevator N Hot food distribution groups are provided with “group separation operation” N Nourishment distribution controls and a dedicated set of car operating-panel N Housekeeping, stationery and administrative equipment and hall-call stations, and indicators for rear-entrance supply trolley operation. Using a “group separation control,” the pub- N Scan/portable medical equipment movement lic elevator is removed from the group and becomes a N Pharmacy/clinical supply trolley single service elevator. It then operates exclusively N Waste collection (medical and nonmedical) trolley based on commands from the rear-entrance controls. N Sterile items supply trolley Continued (a) Patient beds (b) Housekeeping trolleys (c) Meal delivery carts (d) Dirty linen carts (e) Clean linen carts (f) Automated guided vehicles Figure 1: Types of service traffic within a hospital 54 | WWW.ELEVATOR-WORLD.COM | March 2011
  • 3. Building Design Continued N Janitor, maintenance and support staff movement with a specific predetermined route to approach and exit the tools and trolleys service elevator. This route is typically laid away from the In addition to the general service traffic, non-ambulatory main circulation routes and calls for more time spent to patients’ movement is also necessary to move patients to reach a destination, which is often directly above the origin. treatment/scan areas and operation theaters. Here, two Additional costs: A dedicated service elevator adds to to three attendants accompany a patient. Depending on the project’s investment, operating and maintenance costs. the number of beds, transport cart sizes, dimensions and It also mandates additional expenses on the structural volume of materials and various other operational factors, elevator core; mechanical, electrical and plumbing service; the required number of elevator trips must be calculated, fire and life-safety equipment; communication systems; and and the total duration of elevator usage for hospital traffic building-management equipment. movement must be calculated. Swing Public/Service Elevators Dedicated Service Elevator Concerns Advantages Some concerns of healthcare planners about swing Improved traffic flow: In large hospitals with a consid- public/service elevators include the following: erable number of upper floors and high occupancy rates, N Public traffic into sanitized service zones: There is no the service traffic is high. By segregating and diverting control of visitor movement, and visitors could penetrate the service traffic to the dedicated service elevator, the other hospital zones. These are usually kept sanitized public elevators’ performance is unaffected with regard and are prone to contamination from visitor traffic. to waiting times and trip times, especially during peak N Cross infection between patients and visitors: Patients hours. Also, public lobbies are clear of obstructions, sick with communicable diseases can infect unsuspect- enabling faster public passenger transfers in and out of ing visitors. Similarly, visitors with or who recently had elevator cars. Apart from everyday traffic, damage and communicable diseases can transfer germs to newborns repair is restricted only to the dedicated service elevator, and patients with weak immune systems. and “time lost in repair” does not affect the performance N Unpleasant experience and breach of privacy: For vis- of the public elevator group. itors, looking at patients on wheelchairs/stretchers Improved hygienic conditions: Patients within a hospi- could be an unpleasant experience. Similarly, a patient’s tal have weak immune systems and are thus prone to privacy is breached when unknown visitors see the infections. By using exclusive bed service elevators for patient, possibly causing embarrassment to the patient. patient movement, infectious germs and contaminating N Tidiness and hygienic environment: General service agents brought in by the visitors are restrained from traffic (materials, food, supplies, etc.) brings in debris, spreading to the patients. Also, any undesirable personal dirt, odor, spillover and stains. When not cleaned and hygiene practices of service elevator users is limited to sanitized properly, these can cause mold and fungi the service elevator. Finally, improper disinfection and buildup inside the elevator car. Thus, a healthy envi- sanitizing of car interiors, and dirt, mold and fungi buildup ronment cannot be guaranteed within general service and odor inside a service elevator could otherwise affect elevator cars at all times. a sick patient. N Injuries and health risks: General service traffic could Contact/droplet/airborne germs are generally present leave behind sharp objects, fluid leaks and radioactive in a common/public service elevator, as it carries sick objects inside the public car. Sharp objects could cause patients. Such germs can infect visitors when they touch injuries to visitors and cause further infection. Haz- contaminated surfaces and objects (such as handrails or ardous healthcare waste could leave behind traces of push buttons). By using a dedicated bed service elevator, infectious agents and spread to visitors, causing fur- visitors are protected against such infections. This also pro- ther infections. tects visitors against hazardous wastes and sharp objects. Other concerns about these elevators are: Disadvantages N Service elevators have larger capacities when com- Larger floor plate: Depending on the preferred service pared to public elevators. However, a service elevator elevator’s location within the plot limit, the floor plate is allowed to operate at a lower speed than public ele- may need to be increased in order to accommodate the vators, only needing to travel between the terminal service elevator cores, lobbies and staging area. A large floors within 60 seconds. However, when part of a service lobby and staging area must be provided to match public elevator group, the “upgraded service elevator” the various turning radii of items moved. Rentable space cannot be slower, but must operate at a high speed in is lost to the dedicated service elevator. order to satisfy the criterion of travel time between Restrictions on material and service personnel flow: destination floors. (The public elevators in a hospital With a dedicated service elevator, the operatives should use must travel between the terminal floors within 24 sec- 56 | WWW.ELEVATOR-WORLD.COM | March 2011
  • 4. onds.) In effect, this combination increases the initial elevator is part of a public elevator group, then any fire equipment cost. at the public elevator area will shut down the eleva- N Housekeeping, service and maintenance operatives tors, including the service/firefighter’s elevator. This (with their tools and carts) must share the same lobby will deprive the firefighters of an effective means of as the visitors do. Visitors find it difficult to move in vertical transportation for firefighting and rescuing. and out of the lobby, and this increases passenger Advantages transfer times. This also results in an untidy lobby. N Cost savings: Initial investment cost is reduced, and cost N Depending on the codes followed for a specific project, savings are made by eliminating an additional service there could be a risk of overloading the swing service/ elevator and the related elevator infrastructure equipment. public elevator car beyond the machinery capacity. For Running costs pertaining to operating and maintaining example, Japanese elevator codes (Figure 2) allow 3.75 an additional service elevator are also eliminated. m2 for a 1000-kg capacity bed elevator. When used by N More rentable space: By doubling the usage of a public the public, the same elevator (due to its larger car area) elevator as a service elevator, valuable rentable space could be overloaded up to 80%. This could lead to a is freed on all floors. very unsafe situation. Disadvantages N Service elevators are required to handle large beds, N Cab interiors and entrance architraves of a public ele- furniture, etc. For this purpose, the entrance door size vator could be invariably damaged (even with the use (width and height) of a service elevator is quite differ- of protection pads) when used as a service elevator. ent from that of public elevators. Hence, a service N When damaged, repair takes time and requires shut- elevator’s entrance door stands out in a public eleva- down of the public elevator. Until repaired, it presents tor lobby due to its unusually large size, (Figure 3). an inferior look to the public. Increasing the entrance size of a public elevator to N Odor, dirt, trash and stains are usually left behind after match that of a service elevator would only lead to service use. Continued unnecessary equipment costs. N Since service elevators handle large beds and other Car size (1800) furniture, their lobbies must be spacious in order to accommodate the turning radii with a sufficient working Handrail clearance (Figure 4). When the service elevator is part Approximately 2440 with pump of a public elevator group, the lobby needs to be much attached to end of bed Clear car size (2700) wider and deeper when compared to a public-only 450 1000-1080 lobby width and depth. More rentable space is lost, Trolley/ 2370 equipment which is loss of revenue. 600 (500) N It is always preferred to double the role of a service elevator as a firefighter’s elevator. When there is a dedicated service/firefighter’s elevator (away from the public elevator group), it results in “redundancy by location,” as any fire in the public elevator area will not affect the service/firefighter’s elevator. However, if this 1370 Car size, Rated capacity Equ. rated capacity Actual capacity as area as per JEA as per JEA as per EN 81-1 per CIBSE Guide D 1500 mm x 2500 mm 1000 kgs. (13 persons) 1830 kgs. (24 persons) 19 persons 3.75 sq. mtrs. Width of space for attendants Figure 2: Comparison of car areas according to Japanese and European codes to turn bed 180 degrees (3370) 4310 (3980) Length of space for attendants (a) Passenger elevator (b) Passenger elevator (c) Service elevator to turn bed 180 degrees Figure 3: The larger entrance of a service elevator in a public elevator lobby Figure 4: Extra lobby width is required to accommodate the turning radius of presents an odd look. a large, motorized bed. March 2011 | ELEVATOR WORLD | 57
  • 5. Building Design Continued N Negative effects on the originally planned handling N Use heavy-duty floor tiles with good tile grip or check- capacity and waiting time of the public elevator group. ered plate flooring within the elevator car. N Under certain conditions (such as defective controls or N Use coved-end flooring to facilitate easy cleaning a lost key), the service operatives may end up using the (Figure 5). first available elevator in the public group for service N Use easy-to-clean, smooth stainless-steel finishes for traffic. All the elevators in a public elevator group will cabin interiors. then be exposed to these disadvantages. N Verify elevator interface requirements with automated Design Considerations guided vehicles. Dedicated Service Elevator N Allow for bumper/crash rails inside the car on all three If planning a dedicated service elevator or bed service sides. elevator, the following should be considered: N Allow for kick plates at the bottom level of the car to N Based on number of floors and beds, and operational absorb tire impacts. factors, estimate the required quantity and intensity of Swing Public/Service Elevators bed, wheelchair, trolley and cart movements, and If planning a swing public/service (or a swing other maintenance/service personnel movements. public/bed service) elevator, the following should be N Estimate the “running elevator hours” consumed exclu- considered: sively for bed/material movement. Justify the require- N Estimate the required quantity and intensity of move- ment for a dedicated service elevator. ments and “running elevator hours” as described above. N Estimate car floor size, car clear height according to If this figure is large, do not use a swing public/service desired cart/trolley sizes and their quantity per trip, elevator. and the size of the largest equipment moved through N Schedule the service trip timing so as not to clash with the elevator. peak-hour public traffic. N Estimate payload capacity according to the desired cart/ N Avoid hot food distribution, which can create intense trolley loads per trip and the weight of the largest traffic within a short duration (usually within 20 min- equipment moved through the elevator. utes). Instead, allow for devices at each floor to reheat N Allow for a service entrance lobby with suitably sized the food. staging and operating space. The lobby must be self- N For nonperishable items (such as linen and adminis- contained without extending into other functional space. trative supplies), provide storage shelves at upper floors N Allow for sufficient lobby width for the turning radius and replenish stock during off-peak hours. of the equipment with the longest dimensions. N Do not also use the public entrance lobby for service N Estimate door clear width and height according to the traffic. Always provide dedicated rear service entrance largest equipment dimensional requirements. and a rear service lobby. N Locate the service elevator core away from public ele- N Use special operating modes, communication devices, vators to increase the redundancy level during fire delay alarms and visual indicators, forcing operators to emergencies. use the swing public/service elevator sensibly and to N Verify the availability and connecting lobby to the alter- return the elevator to public service promptly. nate service elevator should the main one fail. N Avoid dirt-catching, hard-to-clean crevices, recesses and joints inside the car. Figure 5: Coved-end flooring Figure 6: Card reader control inside elevator car 58 | WWW.ELEVATOR-WORLD.COM | March 2011
  • 6. N Devise suitable operational procedures (forms) to con- N Maintain schedules for regular cleaning and sanitizing trol and authorize the use of a public elevator as a service elevator cars. Conduct regular audits on schedule service elevator (Figure 6). compliance and surprise checks on the car interiors. N Allow for crash rails and permanent hooks at the top level Conclusion of the car for removable car protection pads (Figure 7). A hospital is a space for the sick to recuperate, and it Operation and Maintenance Considerations should provide a comfortable healing experience for pa- In both dedicated and swing service elevators, imple- tients and chaperones. For visitors, a hospital is also a space menting the following operational procedures can help that should be hygienic. For healthcare professionals, a hos- organize the service traffic evenly and improve public pital should also be functional, and easy to use and maintain. health and hygienic conditions within a hospital: A hospital operator cannot afford any shortcoming on N Devise and implement material/service personnel move- patient comfort, hygiene or public health. This could be ment policies and monitor compliance. Address issues detrimental to the business aspirations of the hospital. such as authorized usage and approved timelines for Expert selection and arrangement of transportation and service elevator usage, and record the duration of serv- circulation elements are extremely essential in order to ice elevator usage. maintain high levels of patient comfort, patient privacy N Include access security (card readers, passwords and and public health. As consumer demand and awareness keys) for gaining exclusive command of elevator car for services and quality of services increase, it is the (Figure 6). author’s understanding that a dedicated service elevator N Include floor access security for sterile floors, burns- will soon become the norm of the healthcare industry. References unit floors, etc. [1] AIA Guidelines For Design And Construction Of Health Care Facilities: 2006. N Always use fully covered trolleys and carts, and soak- [2] Health Technical Memorandum 08-02: Lifts: 2010. [3] CIBSE Guide D: Transportation Systems in Buildings: 2005. free disposal bags to transport loose or sharp objects. [4] Japanese Industrial Standard A 4301:1983: Sizes of car and hoist way of Handle odor and stains securely and discreetly. elevators. (b) Car protection pad (c) Entrance protection pads (a) Car with complete accessories: kick plate, handrail and crash rails (d) Crash rail with handrail Figure 7: Elevator car and entrance protection March 2011 | ELEVATOR WORLD | 59