Name: Jeremy Joshua Santosa

Class: MHM 8
Subjects: OT, Ward and Floor Management

Hospital Emergency Department Facility Audit Report

1. Background
Emergency Department Department of Berkah District General Hospital, located in
Pandeglang District, Banten Province, Berkah Regional General Hospital is a type B hospital
based on accreditation of the Republic Indonesia Ministry of Health with a total of 780
treatment ward beds, which are divided into 500 class 3 nursing beds, 200 nursing beds class
2, 120 care beds class 1 and vip. In this hospital, the emergency room consists of a triage
room, a decontamination room, a patient resuscitation room, a surgical patient management
room, a non-surgical patient management room, a nurse station, and a free room to improve
the mobility of patients and medical personnel. Each patient handling section consists of 10
patient beds, with an average number of visits of 68 patients / 24 hours (calculation is done in
1 year). Each shift in the emergency department is served by 4 general practitioners, 8 nurses,
2 patient transport officers, 1 radiographer for emergency radiology, 1 pharmacy officer, and
4 janitors.

2. Standardization
The standard used in conducting audits of emergency department buildings is the 2017
National Hospital Accreditation Standards Guidelines (SNARS). With reference to the
applicable laws and regulations in Indonesia

1. Law No. 23 of 1992 concerning Health

2. Decree of the Minister of Health of the Republic of Indonesia No. 436 / Menkes / SK / VI /
1993 regarding the enactment of Hospital Service Standards

3. Decree of the Minister of Health of the Republic of Indonesia No 0701 / YANMED /

RSKS / GDE / VII / 1991 Concerning Guidelines for Emergency Services

4. Law No. 29 of 2004 concerning Medical Practice

5. Law No. 8 of 1999 concerning Consumer Protection

2.1 Building Architecture

2.1.1 Location
• Emergency room buildings are located on the ground floor with easy access, especially for
patients who come by using wheel chair.

• The entrance to the emergency room building must be separate from the main entrance of
the hospital or with the entrance for outpatients / polyclinics. or the entrance to the hospital
supporting building.

Example Location of Emergency Room Building (ER)

• The location of emergency room buildings must be easily recognized from the road using
either lighting or directional signs.

• Hospitals that have a footprint that extends along the length of the highway, then the
entrance to the emergency room is recommended to be located at the entrance that was first
encountered by the user of the vehicle to enter the area of the hospital.
• Emergency room buildings are recommended to be located close to the admissions
department, the financial department and the medical records section, or have separate
sections. At night, the emergency room building will be the main entrance to the hospital for
people who need health services.

• Emergency room buildings have quick and easy access to the operating room building
location, Emergency Room, obstetrics room, laboratory and hospital blood bank, and 24-hour
pharmacy.

• Emergency room buildings are recommended to have areas that can be used for handling
victims of mass disasters.
Emergency Room Layout Layout On Hospital Site.

2.1.2 Design

• Things that need to be considered when designing an emergency room is that the entrance
of the ambulance must be large enough to accommodate more than two ambulances. The
ambulance entrance in front of the emergency door to lower the passengers must be protected
from the weather. Ambulance parking must be available in addition to medical staff and
visitors.

• Because visitors and patients always come in a hurry and experience panic, the arrangement
of the patient's flow must be good, so the design of this section should create an atmosphere
of good community relations.

• The design must allow speed of service can be done, if there are obstacles in the flow that
slow down service will give a bad impression in providing emergency emergency services.
• Layout of rooms in emergency room buildings may not allow cross infection.

2.1.3 Spatial Planning.

• Spatial planning will follow the flow of services starting with the Triage area, which should
also be prepared as well as stretcher bay and wheel chair storage areas.

• Patients who are emergency or need immediate help will be handled in the action room, and
patients who are emergency or there is a threat of death will be handled in the resuscitation
room, while patients who are not emergency will be treated in false emergency or polyclinic
24 hours.

• Public areas, especially patient family waiting rooms, are recommended to be equipped with
toilets and canteens (caffees / snack bars).

• Decontamination areas are designated for patients who are contaminated with chemicals,
especially for emergency room close to the industrial area. This area is placed on the front /
outside of the emergency room or separated from the emergency room. 

Emergency Department Facility Audit Report

1. Entering Room

No Cek
Room Name Function Facilities Needs
. List
The room where the
family / patient
introduction is waiting. Chairs, Tables,
This space needs to be Television & Air
Family Waiting
1 provided / equipped: Conditioning
Room
Equipment, Public
1. Seating with Telephones, etc.
sufficient amount +
2. Toilet dan wastafel +
 3. Security / security
area +
4. Public telephone -
5. Information and +
Communication Room

This space is used to

carry out Tables, chairs,
administrative file / file cabinets,
Administration activities, including: intercoms /
2
room telephones, safety
boxes and other
1. Patient registration office equipment. +
2. Finance +
3. Medical Record +
Space where sorting
out the patient's sink, simple
3 Triage Room condition, true inspection kit, +
emergency or false label
emergency.
Patient safety deposit
Stretcher / gurney
4 box parking / parking Brankar/ stretceher +
storage room
ready when needed.
Room to clean /
decontaminate the
Shower and sink,
R.Decontamination patient after dropping
cupboard /
5 (For Hospitals in off from the +
decontamination
Industrial Areas) ambulance and before
tool rack
entering the triage
area.
Open area with /
Areas that can be used for the handling of without cover, +
6
victims of mass disasters. clean water and
drainage facilities

2. Treatment Room

Cek
No Room Name Function Facilities Needs
List
 Medical devices
that must be
present in all *
(stars):
Nasopharingeal
tube,
Oropharingeal
tube, children
laryngoscope set,
adult laryngiscope
set, Endotracheal
tube, Laryngeal
Mask Airway,
Suction Machines,
Bag Valve Mask
(Children and
Adults), Oxygen
Filter, Oxygen
Mask (Children)
and Adult), Chest
The room is used to Tube,
carry out rescue Cricotyrotomy,
Resuscitation
1. measures for ECG, Vein  +
Room
emergency patients Section,
due to ABC disorders. Defibrillator,
Gluko Stick,
Stethoscope,
Thermometer,
Nebulizer,
Medical Oxygen,
Neck Colar,
Splint, Long Spine
Board, Scoop
stretcer, KED,
Urine bag, NGT,
Wound Toilet
Set .* I & optional
in * II:
Tracheostomy set,
Ventilator
Transport, Vital
Sign Monitor,
Infusion Pump,
Syringe Pump,
Warmer.
 Medical devices
that must be
available at all *
(stars):TT action,
Dressing Set, Pole
Infusion, Action
lamp,
Thermometer,
Stethoscope,
Suction,
Space for light Sterilisator,
2. Surgery  +
surgical operations Splinting, Splint,
Incubator, Micro
Drips Alkes Set
which must be in *
II, III & IV, may
not be in * I:Vein
Section Set,
Toracosynthesis
Set, Metal
Cautery, Film
Viewer, CPAP.
 Medical
equipment that
must be available
at all * (stars):
Gastric Kumbah
Set, ECG, Gurney,
Irrigator,
Nebulizer,
Suction, Medical
Oxygen, NGT,
Head Lamp,
Space for non-surgical Otoscope Set, Pole
3 Non Surgical  +
procedures Infusion. Medical
devices that must
be in * IV, may
not be in * I, II,
III: Bronchoscopy
Medical devices
that must be in *
III & IV, but not
in * I, II: Syringe
Pump,
Ophtalmoscope,
Infusion Pump

Inkubator, Mikro
Space for pediatric
4 Pediatric Drips Set, Cpap  +
patient action
(optional di * I)

Curette Set, Partus

Set, Baby Suction,
Gynecology
Table, Partus
Table, Vacuum
Room for midwifery Set, Forcep Set,
5 Midwifery  +
treatment CTG,
Resuscitation Set,
Doppler, Baby
Suction, Infusion
Pole, TT, Film
Viewer.

6 Observation Room Space to make vital sign  +

 observations on
patients after being
examination tool
given medical
treatment.
Space for planning,
organizing, nursing
services, scheduling,
documentation and
patient evaluation. Tables, chairs,
7 Nurse Station Nurse posts must be sinks, computers,  +
located in the center etc.
of the block that is
served so that nurses
can supervise their
patients effectively.

3. Medical Supporting Room

Cek
No Room Name Function Facilities Needs
List

Space for storing

1 Pharmacy Room medicines for Medicine cabinet + 
emergency room needs

Linen Storage Space for storing clean

2 cabinet  +
Room linen materials.
Space for storing
medical equipment that
is needed at any time.
Medical Instrument Equipment that is kept
3 Instrument cabinet  +
Room in this room must be
ready to use and in a
clean / sterile
condition.

Mobile X-Ray,
mobile ECG,
Place to carry out
Cito Radiology apron timbal,
4 CITO diagnostic  +
Room automatic film
activities.
processor, dan film
viewer.
 Routine labs,
electrolytes, blood
Cito laboratory
chemistry, blood
Standard examination rooms for
5 gas analysis,  +
Laboratory certain types of
(CKMB (heart)
examinations.
and special labs
may or may not)

Workspace, rest room,

discussion of
emergency room Sofa, cupboard,
6 Staff Room officers, namely the table / chair, sink,  +
head of emergency pantry.
room, doctor, consulent
doctor, nurse.

Facilities for removing

Goose neck toilet,
impurities used by
clean water tap
patients, especially in
(Sink), Note: the
Spoolhoek/Dirty the form of liquid.
7 height of the toilet  +
Utility Spoolhoek in the form
lip + 80-100 m
of a tub or toilet
from the surface of
equipped with a swan
the floor
neck (water seal).
8 Staff Toilet Toilet    +

Place for carrying out Workbench, 1 sink

sterilization of / 2 sinks complete
9 Sterilization Room instruments and other with clean water &  +
items needed in the wastewater,
Emergency Room. autoclave.

Space for storing

belongings of
10 Locker Room Locker  +
emergency staff / staff
and changing rooms.

3. Conclusions

Based on the standardization of facilities and emergency department buildings in the

Pandeglang district hospital, generally the prerequisites must be fulfilled well and in
accordance with the minimum requirements required by the National Hospital Accreditation
Standards Guidelines (SNARS). However, there were still a number of limitations, where the
equipment and space required were already available and standardized but in their use they
were often found to be not optimal or did not run according to the standard operating
procedures set by the hospital, so it could be concluded that the facilities and infrastructure
that exist in the Pandeglang district republic hospital berkah emergency department have
fulfilled the standards set by SNARS 2017, but in their utilization and use they still require a
lot of improvement and

supervision from the hospital management.

References

1. SNARS.web.id. technical guidelines for hospital emergency room buildings 2017.

accessed on 14 July 2020, from : https://snars.web.id/rs/pedoman-teknis-bangunan-rumah-
sakit-ruang-gawat-darurat/.

2. Eirish Association for Emergency Medicine, 2007. Standards for Emergency Department
Design and Specification for Ireland 2007. Ireland.

3. A Windokun 1, A Obideyi.  2002. Audit of emergency theatre utilisation. Afr J Med Med
Sci. 2002 Mar;31(1):59-62.