Quick Overview
SpaceMed Expert gives you quick access to the rules-of-thumb for all the clinical services and support functions found in the SpaceMed Guide (fourth edition). Whether you are a seasoned healthcare architect or planner — or new to the healthcare industry — this mobile app can be used to evaluate existing space, develop preliminary space estimates for master planning or feasibility studies, or to impress your associates and clients on the go.
Net square meters (NSM) refers to the usable space within a room or area (inside wall-to-wall dimensions).
Department gross square meters (DGSM) includes the net space of all rooms or areas within the department plus the space occupied by intradepartmental circulation and the internal walls and partitions — accounting for an additional 20–50 percent more space over the department net square meters. DGSM is typically used in the preparation of block schematic drawings. The term component gross square meters (CGSM) is interchangeable with DGSM.
Floor gross square meters (FGSM) and building gross square meters (BGSM) represent the overall footprint of a floor or building, respectively, and include shared public corridors and atriums, elevators, stairs, space occupied by the building's exterior wall, and major mechanical spaces — accounting for an additional 20–30 percent more space over the DGSM. In some cases, the total building gross square meters (BGSM) may require 8–12 percent more space than the FGSM to allow for major mechanical spaces and a power plant, depending on the scope of the project.
Average Annual Visits per Treatment Space
| 1,100 – 1,200 | Low performance (or trauma center) — average treatment space turnaround time of 210 minutes |
| 1,200 – 1,600 | Average performance — average treatment space turnaround time of 150 minutes |
| 1,600 – 1,900 | Best practice (or urgent care center) — average treatment space turnaround time of 120 minutes |
Emergency / Urgent Care Space (DGSM)
| 51.1 – 60.4 | Per emergency department (ED) treatment space |
| 41.8 – 51.1 | Per urgent care center (UCC) treatment space |
Net-to-Gross Space Conversion
| 1.50 – 1.60 | Emergency department |
| 1.45 – 1.50 | Urgent care center or observation unit |
Key Space Allocation Factors
- Acuity of the patients to be treated — higher acuity patients require more treatment space
- Percent of patients admitted to the hospital and inpatient bed availability — potentially resulting in the boarding of admitted patients in the ED
- Scope of diagnostic services provided within the ED or UCC
- Number of specialty pods in the ED — such as pediatrics, behavioral health, chest pain, stroke, geriatrics, observation
- Average general treatment cubicle turnaround time is 150 minutes — ideal target of 90 minutes for nonurgent care or fast track and less than six hours for emergent or admitted patients
Annual Cases per Operating or Procedure Room
| 1,000 – 1,250 | General or special surgery operating room (outpatient surgery suite) |
| 600 – 1,000 | General or special surgery operating room (hospital-based surgery suite) |
| 500 – 700 | Hybrid operating room or Class 3 imaging room (hospital-based surgery suite) |
| 1,200 – 1,800 | Endovascular procedure room (endovascular procedure suite) |
Surgery / Endovascular Space (DGSM)
| 232.3 – 325.2 | Per general / special surgery operating room (outpatient surgery suite) |
| 260.1 – 315.9 | Per operating / procedure room (hospital-based surgery suite) |
| 185.8 – 232.3 | Per endovascular procedure room (endovascular procedure suite) |
Perioperative Care Patient Spaces
| 1.0 | Per each Class 2 and Class 3 imaging, procedure, or operating room for a pre-procedure care unit (separate) |
| 1.0 | Per each Class 2 and Class 3 imaging, procedure, or operating room for a Phase II outpatient recovery unit (separate) |
| 1.5 | Per each Class 2 and Class 3 imaging, procedure, or operating room for a combined pre-procedure care and Phase II outpatient recovery unit |
| 1.0 | Per each Class 2 and Class 3 imaging or operating room for a post-anesthesia care unit (PACU) |
Net-to-Gross Space Conversion
| 1.55 – 1.60 | Surgery suite or endovascular procedure suite |
Key Space Allocation Factors
- Economies of scale achieved by larger suites
- Size and specialization of the individual operating rooms (ORs) — general ORs at 37.2 NSM versus specialty ORs at 55.7+ NSM
- Proportion of outpatients — who require more pre-procedure prep and post-procedure (Phase II) recovery space
- Type of patient care spaces for perioperative care — use of larger private rooms for pre-surgery preparation and outpatient Phase II recovery requires more space
- Architectural design — requiring excessive corridor space resulting in a large net-to-gross space conversion factor
Average Annual Visits per Procedure Room
| 6,500 – 7,500 | General radiology room |
| 7,500 – 8,500 | Chest imaging room |
| 2,500 – 3,500 | Fluoroscopy room |
| 3,500 – 5,000 | Bone density room |
| 3,500 – 5,000 | Breast imaging room (standing) |
| 1,500 – 2,500 | Breast imaging room (prone) |
| 2,000 – 3,500 | Ultrasound room |
| 5,000 – 7,500 | Computed tomography (CT) scanning room |
| 3,500 – 5,000 | Magnetic resonance imaging (MRI) room |
| 2,500 – 3,500 | Nuclear medicine scanning room |
Imaging / Diagnostic Space (DGSM)
| 74.3 – 92.9 | Per radiology room (general radiology, chest imaging, fluoro, and bone density) |
| 69.7 – 79.0 | Per breast imaging room |
| 55.7 – 65.0 | Per ultrasound room |
| 111.5 – 139.4 | Per CT scanning room |
| 130.1 – 157.9 | Per MRI scanning room |
| 115.5 – 148.7 | Per nuclear medicine scanning room |
Net-to-Gross Space Conversion
| 1.40 – 1.50 | General radiology and nuclear medicine |
| 1.35 – 1.45 | Separate outpatient ultrasound or similar diagnostic services |
Key Space Allocation Factors
- Acuity of the patients to be treated — outpatient imaging suites have quicker procedure room turnaround times than hospital-based services with a high proportion of inpatients
- Facility layout — organization of multiple imaging modalities around a central patient check-in and waiting area provides more efficient space utilization than separate storefronts for each modality
- Central physician viewing / reading area within the department versus remote space
Bed Need Forecasting Formulas
- Patient days (PD) = hospital admissions x average length of stay (ALOS)
- Average daily census (ADC) = patient days ÷ 365
- Inpatient bed need = ADC ÷ target occupancy rate (70-90 percent)
Patient Care Unit Space (DGSM)
| 51.1 – 74.3 | Per bed (general medical, surgical, or intermediate care unit) |
| 60.4 – 83.6 | Per bed (intensive care unit) |
| 55.7 – 79.0 | Per bed (skilled nursing or rehabilitation unit) |
Net-to-Gross Space Conversion
| 1.50 – 1.60 | Inpatient nursing unit |
Key Space Allocation Factors
- Number of beds and configuration of the general care unit — typical range of 32-36 beds per unit that can be subdivided into modules supporting a 1:4 nurse-to-patient ratio
- Patient room size, configuration, and amenities
- Accommodation of special patient populations — airborne infection isolation (AII), protective environment (PE), and individuals of size
- Decentralization of clinical and support services to the patient care unit
- DGSM per bed is significantly higher for a very small ICU than for a larger unit
Average Annual Births per Procedure Room
| 2,000 | Cesarean delivery room; backup room needed for peak times; maximum three rooms |
| 100 – 200 | Combined labor, delivery, recovery, and postpartum (LDRP) room using single-room maternity care |
| 300 – 400 | Labor, delivery, recovery (LDR) room where mother and baby are transferred to a separate postpartum room after recovery |
Maternal / Infant Space (DGSM)
| 74.3 – 92.9 | Per LDRP or LDPR room |
| 41.8 – 65.0 | Per antepartum or postpartum bed |
| 41.8 – 55.7 | Per neonatal intensive care (NICU) bed |
| 232.3 – 278.7 | For a cesarean delivery suite with two operating rooms |
Net-to-Gross Space Conversion Factor
| 1.50 – 1.60 | Birthing, antepartum, or postpartum unit |
| 1.45 – 1.55 | Special care nurseries |
Key Space Allocation Factors
- Patient care model — single room maternity care (SRMC) with labor, delivery, recovery, and postpartum care occurring in the same (LDRP) room is generally used for small-volume services; large-volume services often transfer the mother and baby to a separate postpartum room after recovery (using an LDR room and a postpartum room)
- Percent of patients with cesarian deliveries and induced births
- Location of cesarean delivery rooms — within perinatal suite or located in a surgery suite
- Rooming-in policy (where babies stay with mothers) and the size of the well-baby nursery
- Configuration of the special care nurseries — single-family rooms (SFRs), semi-private rooms, open-bay units, and neonatal couplet care rooms
- Size and scope of the triage / admission area and perinatal diagnostics
- DGSM per bed is significantly higher for a very small NICU than for a larger unit
Behavioral Health Space (DGSM)
| 55.7 – 79.0 | Per inpatient behavioral health bed |
| 9.3 – 13.9 | Per day patient in intensive outpatient / partial hospitalization program (IOP / PHP) when combined with an inpatient unit |
Net-to-Gross Space Conversion
| 1.50 – 1.55 | Inpatient behavioral health unit |
| 1.35 – 1.40 | Outpatient behavioral health services |
Key Space Allocation Factors
- Programs, services, and special therapies to be provided — such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS)
- Outpatient behavioral health programs vary widely and typically include space for one-on-one interviewing and consultation, rooms for group therapy, and optional spaces for testing and special procedures
Outpatient Physical / Occupational Therapy Space (DGSM)
| 102.2 – 130.1 | Small facility — two to three private treatment cubicles, small gym at 37.2 NSM, two to three staff workstations, and support space |
| 232.3 – 297.3 | Medium facility — four to seven private treatment cubicles, medium gym at 74.3 NSM, four to seven staff workstations, and support space |
| 371.6 + | Large facility — eight private treatment cubicles, larger gym at 92.9 NSM, eight staff workstations, and support space |
Net-to-Gross Space Conversion
| 1.35 – 1.40 | Physical and occupational therapy |
| 1.30 – 1.35 | Speech therapy and hearing services |
Key Space Allocation Factors
- Programs, services, and special therapies to be provided — such as hydrotherapy
- Occupational therapy includes workstations for light activities — hand therapy, splinting, and crafts — as well as heavy activities using floor-mounted machinery or dance and movement therapy
- Although speech and hearing services typically include a fixed, prefabricated sound suite, most other testing equipment is portable or mobile
Oncology Space (DGSM)
| 650.3 – 743.2 | For the first linear accelerator (LINAC) or Gamma Knife treatment room |
| 464.5 – 557.4 | For each additional LINAC or Gamma Knife treatment room |
| 27.9 – 33.4 | Per medical oncology or infusion therapy treatment bay, cubicle, or room |
| + 65.0 – 92.9 | Optional satellite pharmacy |
Net-to-Gross Space Conversion
| 1.35 – 1.40 | Medical oncology / infusion therapy |
| 1.50 – 1.55 | Radiation therapy suite |
Key Space Allocation Factors
- A radiation therapy service requires one or more LINACs but generally no more than four; additional modalities include a Gamma Knife and brachytherapy, along with various types of treatment planning equipment
- A dedicated LINAC performing conventional radiation therapy can accommodate about 6,500 annual treatment per machine
- A satellite pharmacy may be incorporated into the medical oncology / infusion therapy center depending on the extent of purchased or outsourced services, such as the compounding of hazardous sterile preparations.
Physician Practice or Clinic Space (DGSM)
| 83.6 – 111.5 | Per physician / provider (primary shift) or |
| 41.8 – 55.7 | Per exam room |
Other Treatment Space (DGSF)
| 32.5 – 41.8 | Per treatment room (dental suite) |
| 23.2 – 27.9 | Per treatment station (renal dialysis center) |
Outpatient Endoscopy Suite Space (DGSM)
| 139.4 – 185.8 | Small suite — two to three procedure rooms |
| 116.1 – 139.4 | Medium suite — three to four procedure rooms |
| 92.9 – 116.1 | Large suite — five to six procedure rooms |
Net-to-Gross Space Conversion
| 1.35 – 1.45 | Physician practice space, outpatient clinics, and renal dialysis centers |
| 1.30 – 1.35 | Ophthalmology / optometry suites and dental suites |
| 1.40 – 1.50 | Medical procedure units |
Key Space Allocation Factors
- Private physician practice space is typically planned based on the number of physicians or other providers scheduled at a given time and assuming two exam rooms per provider
- A physician seeing patients 40 hours per week, for an average of 30 minutes each, with an exam room utilization rate of 70-85 percent, will see 2,500–3,000 patient per year
- An endoscopy room can accommodate an average of 1,250–2,000 annual tests
- The services provided in a medical procedure unit vary widely and may include endoscopy, hyperbaric oxygen therapy, and intravenous therapies, as well as injections and pain management procedures
Outpatient Pharmacy Space (DGSM)
| 46.5 | Minimal — less than 100 daily scripts |
| 83.6 – 92.9 | Small — 100 to 300 daily scripts |
| 148.7 – 204.4 | Medium — 300 to 500 daily scripts |
| 213.7 + | Large — Over 500 daily scripts |
Net-to-Gross Space Conversion
| 1.25 – 1.35 | Hospital-based, outpatient, or satellite pharmacy |
Key Space Allocation Factors
- Pharmacies must comply with strict regulations established by U.S. Pharmacopeia (USP 800, 797, and 795) for handling hazardous drugs — from receipt to storage, compounding, dispensing, administration, and disposal
- A manual workstation in a pharmacy generally requires 5.6 NSM, excluding additional space for computers, fax machines, printers, open shelving, and secure and refrigerated storage
- Pharmacies may include high-density storage carousels, controlled substance towers, unit dose packagers, automated storage systems, and completely automated packaging, storage and dispensing systems
- ⚠ CAUTION: Hospital pharmacies are increasingly automated and the vendor specifications will dictate the overall footprint, appropriate clearances, and supporting infrastructure
Outpatient Specimen Collection Space (DGSM)
| 37.2 – 55.7 | One phlebotomy tech |
| 55.7 – 69.7 | Two phlebotomy techs |
| 69.7 – 92.9 + | Three or more phlebotomy techs |
Small Laboratory Space (DGSM)
| 185.8 – 223.0 | Core laboratory |
| 46.5 – 55.7 | Microbiology |
| 46.5 – 55.7 | Transfusion services / blood bank |
| 65.0 – 74.3 | Anatomical Pathology |
| 74.3 – 92.9 | Common laboratory support space |
| 139.4 – 167.2 | Staff / administrative space |
Medium Laboratory Space (DGSF)
| 223.0 – 390.2 | Core laboratory |
| 55.7 – 111.5 | Microbiology |
| 55.7 – 83.6 | Transfusion services / blood bank |
| 74.3 – 139.4 | Anatomical Pathology |
| 92.9 – 111.5 | Common laboratory support space |
| 167.2 – 185.8 | Staff / administrative space |
Large Laboratory Space (DGSM)
| 390.2 – 650.3 + | Core laboratory |
| 111.5 – 371.6 + | Microbiology |
| 83.6 – 111.5 + | Transfusion services / blood bank |
| 139.4 – 185.8 + | Anatomical Pathology |
| 111.5 – 139.4 + | Common laboratory support space |
| 185.8 – 241.5 + | Staff / administrative space |
Space for Other Components (DGSM)
| 27.9 – 139.4 + | Molecular testing |
| 65.0 – 83.6 + | Electron microscopy |
Net-to-Gross Space Conversion
| 1.30 – 1.40 | Laboratory components |
Key Space Allocation Factors
- Small laboratories will process less than 250,000 annual tests with less than 20 full-time equivalent employees (FTEs)
- Medium laboratories will process between 250,000 and 500,000 annual tests with between 20 and 40 FTEs
- Large laboratories will process between 500,000 and 1.5 million annual tests with over 40 FTEs
- Not all hospital laboratories will provide microbiology, molecular testing, and electron microscopy
- One blood drawing cubicle should be planned for each phlebotomy tech for outpatient specimen collection
- ⚠ CAUTION: Clinical laboratories are increasingly automated and the vendor specifications will dictate the overall footprint, appropriate clearances, and supporting infrastructure
Minimum Space Allocation (DGSM)
| 92.9 | Central reception area (including an entrance vestibule, visitor lobby and lounge, security station, and public toilets) |
| 37.2 | Patient intake area |
| 27.9 | Gift shop |
| 46.5 | Coffee shop |
| 27.9 | Chapel or meditation room |
Net-to-Gross Space Conversion
| 1.30 – 1.35 | Patient intake services |
| 1.20 – 1.25 | Other components |
Key Space Allocation Factors
- Scope of patient and visitor support services and amenities to be provided
- Potential partnerships with outside vendors — coffee shop, internet kiosks, and retail pharmacy
- Use of electronic communication technologies and paper reduction
Administrative Office Suite Space (DGSM)
| 4.7 – 7.4 | Per open clerical workstation |
| 7.4 – 10.2 | Per open office or cubicle |
| 12.1 – 14.9 | Per private office |
| 16.7 – 22.3 | Per large executive office |
| + 15 – 20% | Additional DGSF for staff support and storage space |
Medical Records Storage
| 75 – 100 | Charts per four-foot shelf |
| 450 – 600 | Charts per shelving unit (with six shelves) |
Net-to-Gross Space Conversion
| 1.25 – 1.35 | Administrative office space |
Key Space Allocation Factors
- Healthcare organizations often create generic administrative office suites with a variety of workstations to accommodate different staff and working styles over time — particularly with increased telecommuting
- The size of an administrative office suite can vary significantly depending on the number of conference rooms and amenities.
- The need for on-site record storage is diminishing with the rapid adoption of electronic health records; however, state laws govern how long medical records are to be maintained
Materials Management Space (DGSM)
| 2.32 – 3.25 | Per occupied bed (traditional system) |
| 0.65 – 0.93 | Per occupied bed (just-in-time system) |
| 0.28 – 0.47 | Per occupied bed (stockless system) |
Central Sterile Processing Space (DGSM)
| 185.8 – 297.3 | Minimal service — two steam/gas sterilizers |
| 297.3 – 418.1 | Average service — two steam sterilizers and one gas sterilizer |
| 418.1 – 511.0 | Large service — three steam sterilizers and one gas sterilizer |
Food and Nutrition Services Space (DGSM)
| 0.84 – 1.39 | Per peak daily meal (conventional) |
| 0.93 – 1.49 | Per peak daily meal (cook-chill or cook-freeze system with on-site production) |
| 0.65 – 1.02 | Per peak daily meal (cook-chill, cook-freeze, or convenience system with off-site production) |
Telecommunications Equipment Room (NSM)
| 92.9 – 111.5 | Small hospital |
| 139.4 – 162.6 | Medium-size hospital |
| 185.8 – 232.3 | Large hospital |
Net-to-Gross Space Conversion
| 1.30 – 1.40 | Central sterile processing and food services |
| 1.20 – 1.30 | All other building support services |
Key Space Allocation Factors
- Overall materials management system — traditional, just-in-time, or stockless — and amount of supplies and equipment stored on-site
- Materials distribution system — requisition, exchange carts, periodic automatic replenishment (PAR), or automated point-of-use supply cabinets
- Waste removal systems — trash, recyclables, soiled linen, and regulated waste
- Food production system — conventional or cook-serve, cook-freeze, cook-chill, or convenience
- ⚠ CAUTION: Due to the high cost of building and operating a hospital kitchen, many organizations hire a food service consultant or outsource this function entirely.
Conference / Meeting Room Space (NSM)
| 1.39 – 1.86 | Per seat for conference rooms |
| 0.65 – 1.30 | Per seat for auditoriums — 1.30 NSM per seat up to 100 seats, additional 0.84 NSM per seat for next 100 seats, and 0.65 NSM per seat beyond 200 seats |
Child Daycare Center Space (NSM)
| 3.3 | Per child over 2 1/2 years for indoor activity space, exclusive of support space |
| 4.7 | Per child under 2 1/2 years for indoor activity space, exclusive of support space |
| 111.5 | Minimum for outdoor activity space |
Employee Fitness Center Space (NSM)
| 7.4 – 9.3 | Per person for a group exercise area |
| 5.6 – 7.4 | Per floor-mounted or weight-training exercise station |
| 27.9 | Minimum for a gymnasium; 92.9-185.8 NSM typical |
| 111.5 | Minimum for a lap pool and deck |
| 16.7 | Minimum for a whirlpool tub and deck |
Staff Lockers / Changing Facilities Space (NSM)
| 2.79 | Per entry alcove or vestibule |
| 1.86 | Per coat rack |
| 0.46 | Per box or handbag locker |
| 0.74 | Per half-width locker |
| 0.93 | Per full-width locker |
Physician Lounge / On-Call Suite Space (DGSM)
| 23.2 | Minimum for a physician lounge (excluding toilet room) |
| 16.7 | Minimum for an on-call suite (including toilet/shower room) |
Staff Toilet / Shower Facilities Space (NSM)
| 2.79 | Per entry alcove or vestibule |
| 2.32 | Per handwashing lavatory |
| 1.39 | Per standard toilet cubicle or urinal |
| 2.79 | Per wheelchair-accessible toilet cubicle |
| 2.32 | Per wheelchair-accessible shower |
Staff Toilet Room (NSM)
| 5.1 | Per wheelchair accessible toilet room |
Net-to-Gross Space Conversion
| 1.25 – 1.35 | Shared staff support services |
Key Space Allocation Factors
- Some institutions rent meeting rooms or auditoriums at universities or hotels as needed, instead of building large meeting spaces that are used infrequently
- As staff more frequently use their own computing devices to access internet-based resources, medical libraries are becoming less common
- Individual states or local jurisdictions usually license child daycare centers
- The need for centralized staff lockers and changing facilities should be based on a survey of each clinical program and support service to identify need