Facility Planning and Design of a Cardiac Catheterization Laboratory Complex in a Tertiary Government Hospital

Purpose: A new catheterization laboratory complex is to be established in a tertiary government hospital, meeting the demand for cardiac procedures as heart disease remains a major threat to Filipinos. Ensuring efficient patient flow and optimized radiation exposure is necessary due to the emergency interventional procedures involved and extended beam-on times. Hence, this study proposes a facility design that aims to simplify patient flow with shielding calculations for radiation safety assessment. Methods: The site location, functions, and dimensions were selected based on cath lab installation guidelines from existing literature. The floor plans were designed to separate staff and patient flow. Shielding calculations for a uniplanar angiography system were conducted in accordance with NCRP 147 guidelines for a 10-patient-per-week workload, considering concrete and lead-based materials surrounding the fluoroscopy room. Results: Three facility designs were proposed on a 20.99 m x 11.20 m floor size for the cath lab and supporting rooms, and all designs had a fluoroscopy floor area of ~53 m2. The first design prioritized staff workflow and staff area size. In contrast, the second and third designs prioritized patient workflow and safety by placing patient areas near the facility entrance, and differed in the placement of a patient amenity room. Based on the Philippine DOH A.O. 35 s.1994, the concrete walls must be at least 152.4 mm, the lead doors must have a 1.5 mm lead sheet, and the control room viewing glass must be 1.5 mm lead equivalent. Our shielding calculations confirmed that all designs met the local regulatory requirements. Conclusion: Based on existing literature and the hospital’s context, the third design is the most appropriate option. The proposed design and shielding calculations may be considered to ensure efficient workflow and optimal radiation exposure for staff and the public.