Aerial View of the Kyorin University Hospital Ward

Aerial View of the Kyorin University Hospital Ward 1 Trauma & Critical Care Central Ward Surgical Ward 3 Ward 2 Outpatinet Clinic

Aerial View of the Kyorin University Hospital Trauma & Critical Care Surgical Ward New Ward 1 Central Ward 2 Outpatinet Clinic MASTER PLAN

Radiation treatment outpatient 1 st ward Parking building Neighbor A Outpatient parking Ne w 1 st ward ro ad Ne w Neighbor B Before(1995) １ 1997. 1 before After(2001) ２ 1997. 2 -1999. 1　constuction-1 Parking building Neighbor A Open outpatient & parking building Move from old one New road Neighbor B ro ad outpatient Open new road ３ 1999. 2 -2000. 12 constuction-2 Move from old ward Radiation treatment 1 st ward Open 1 st ward Replacement (STEP 1)

⑪surgical ward Isolation 2007 ②trauma center 　　1993 ⑧ext. 1 st ward 　2002 ⑩central ward isolation 　2005 ⑥ 1 st ward 　isolation 　2000 Function movement (Finished) Ｎ ③outpatient isolation 1998 ⑫ 3 rd ward isolation 2012 Lecture rooms 1983 gymnasium 1977 library 1975 ④parking 　1999 ⑤radation treatment 2000 Information center 1981 Medical reserch 1974 ① 2 nd ward 　1985 Nursing & medical education 2008（1977） ⑨ext. 2 nd ward 　2003 Nusing school 1989 ⑦ext. 2 nd ward 　2001 Basement isolation

Flat slab Building height machine 個室階 ８Ｆ 3, 400 〃 ７Ｆ ６Ｆ 〃 〃 ５Ｆ Inpatient rooms 32, 524 mm 〃 ４Ｆ 〃 ３Ｆ 4 beds room： 33. 25 ㎡ 7, 300 mm Private room： 17. 64㎡ ICU washbowl ＷＣ cl washbowl cl 〃 ２Ｆ １Ｆ 3, 400 Hospital kitchen Ｂ１ 4, 500 machine Ｂ２ 6, 000 Ｆ Ｆ Basement isolation ＷＣ shower cl corridor 6, 400 mm 3, 200 mm 27, 400 mm Works【central ward】

Beds and Staffs of Kyorin Hospital No. of Beds: 1, 153 Bed Occupancy： 83% LOS： 12 days No. of Staffs: 2, 158 Doctors: 694（Staffs: 548 Residents: 146) Nurses: 1, 373 Office staffs: 91 Outsourcing members: 342 2012. 9

Characteristics of the Hospital Local and Acute Patients from Neighboring Regions: 90% Emergency patients: 35, 000 (5. 3% of total outpatients) No. of Outpatients: 673, 000/ yr No. of Operations: 11, 557 Emergency Ops: 17. 4% of total ops No. of Outpatients　from Yokota Base: 120/ yr No. of Inpatients from Yokota Base 14/yr 2011

Best Ranking Hospital in Tokyo Weekly Journal Diamond 2010 9 th Best Ranking in Japan

Number of Critically Ill Emergency Patients 　　　　（2008. 4～ 2009. 3）　 １　杏林大学高度救命救急センター　　　 １，８０７人 No. 1 in Tokyo!!

Renovation of the Hospital 03 04　05　06　07　08　09・ 12 yrs OR・ICU Supply& Delivery System IT System Surgical Wards, S-ICU, Kitchen New Ward

Seismically Isolated Hospital Implementing a base-isolated structure reduces the seismic acceleration by approximately 60 percent. Unified foundation with lead core 人 地盤断面 93 rubber bearings with lead core To prevent serious damage by a big earthquake, we have adopted earthquakeabsorbing structure in all new hospital buildings.

No shelves for material stock on the wall of OR

Specialized OR for Endoscopic Surgery

Specialized OR for Endoscopic Surgery

Heliport on the roof of new ward Designed for UH-60 BLACKHAWK Rotor diameter 20 m Length 24 m Impact Load 35 t

New Hospital Kitchen　1600㎡ PREPARATION STORAGE COOKING TEST CHILLER WASH CARTPOOL TO OTHER PAVILLIONS REFRIGERATOR SET COOKING STAFF CHECK CART-CHILLER RICE OFFICE WASH OFFICE MILK EV STORAGE ENTRY B 1 F

Concept of Meal Service Ø New cook chill system Ø Cooking, Chilling & Re-heating Ø Special Cart for meal-reheating Ø Special Heat-resistant Plates Ø HACCP（Hazard Analysis and Critical Control Point ) a systematic preventive approach to food safety Ø 　　

Re-Heating Cart　 Temp Monitor Cooling Heating

ER/ Critical　Care Center Angio CR MRI CT Fluoroscopy 　　〈FPD〉

主要放射線機器（Area Detector CT）　 320列 780 mm Wide-Bore＋275 msec Rotation ・Fast total scan times ・Less patient motion ・Freeze pulsation and peristalsis ・Use less contrast media AIDR 3 D 画質を保ちつつ最大限のノイズ＋ストリーク低減

主要放射線機器（ Angio） Multi-axis revolution Artis zeego Large volume 　　　　syngo　Dyna. CT max. 47 cm Axial

5 10 0 0 50分 40分 30分 20分 12時00分 50分 40分 30分 20分 11時00分 受理時間 40分 30分 20分 10時00分 50分 40分 30分 20分 10分 9時00分 50分 40分 30分 20分 10分 8時00分 等候時間Simulation 患者数（人）45 90 40 80 35 70 30 60 25 50 20 40 15 30 10 20 2008年 5月 等候時間（分） 患者数 現状 7人 8人 9人 10人

0 8: 00 0: 00 9: 00 0: 00 10: 00 11: 00 0: 00 12: 00 0: 00 13: 00 0: 00 受付時間 0: 00 40 0: 00 780件 13: 00 10 0: 00 60 12: 00 20 0: 00 100 0: 00 30 11: 00 採血件数 0: 00 40 140 0: 00 待ち時間 0: 00 受付件数 人 10: 00 160 0: 00 50 9: 00 718件 分 0: 00 2010年 1月18日 8: 00 人 0: 00 等候時間的比較 2010年 9月6日 分 50 160 待ち時間 受付件数 140 採血件数 120 30 100 80 80 20 60 40 40 10 20 20 0

Patient flow of Intensive Care Units of Kyorin University Hospital Critical patients Require close observation Tertiary medical care Recovering Cardiac surgery ward ER (ATT) TCC　30 beds ward （Emergency ward） ward Sudden turn for the worse Surgical patients CICU　18 beds （Central ward） Major surgery Minor surgery HCU　 24 beds （The 3 rd ward） Infectious diseases SＩCU　28 beds （Surgical ward） ward

pharmacy Staff station ME Private room Staff zone Family room

Layout of ＨＣＵ Infectious Diseases High Care L e Less critical comparing to CICU&TCC Admission from ER

Zeego用於治療Chronic PE

急診Angio

急診 320切CT

Dr. Saito and CICU

High Care Unit

地下二樓的Isolation