Part B – Health Facility Briefing & Design

16 Adult Cardiac Surgery Unit

International Health Facility Guidelines

2023
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Table of Contents
16. ADULT CARDIAC SURGERY UNIT ........................................................................................................... 3
1 INTRODUCTION ................................................................................................................................................ 3
2 FUNCTIONAL AND PLANNING CONSIDERATIONS...................................................................................................... 3
3 FUNCTIONAL RELATIONSHIPS ............................................................................................................................ 10
4 DESIGN CONSIDERATIONS ................................................................................................................................ 13
5 COMPONENTS OF THE UNIT ............................................................................................................................. 19
6 SCHEDULE OF ACCOMMODATION ...................................................................................................................... 21
7 REFERENCES AND FURTHER READING ................................................................................................................. 27

International
Health Facility Guidelines © TAHPI 2024 Page 2
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

16. Adult Cardiac Surgery Unit

1 Introduction
The Adult Cardiac Surgery Unit (ACSU) is a specially staffed and equipped section of a healthcare
facility for the support, monitoring and treatment of adult patients with a life-threatening or
potentially life-threatening heart condition requiring Cardiac Surgery.
The ACSU will cater for adults of all ages.
The ACSU will only accommodate surgical patients until they are discharged from the hospital or
reallocated to an inpatient unit.
2 Functional and Planning Considerations
Operational Models
The ACSU provides services 24 hours a day, seven days a week.
The level of care available should support the delineated role of a particular hospital. This unit is
suitable for hospitals at the Role Delineation levels (RDL) of 4 to 6.
At RDL 5 or 6 the ACSU may be established as a dedicated Centre of Excellence focussing only
on Adult Cardiac Surgery and all supporting services which are dedicated to Adult Cardiac
Surgery. On the other hand, at all RDL’s from 4 to 6, ACSU may be a fully integrated service
within the larger hospital, using many of the common and shared resources.
The ACSU RDL will vary depending on staffing, facilities and support services as well as the type
and number of patients it has to manage. Please refer to the Role Delineation Guidelines included
within these Guidelines.
Models of Care
The initial diagnosis of the patient is not expected within ACSU. However, once a patient is
diagnosed and it is determined that Cardiac Surgery is necessary, the patient will be referred to an
ACSU for the complete range of services (before, during and after surgery). Therefore, ACSU is
an important part of a referral pattern within the healthcare system.
Examples of the Models of Care that may be implemented include:
▪ Patient allocation, which involves allocation of a group of patients to nursing staff who undertake
complete care and treatment. This model allows staff to become skilled with varying patient care
acuities but requires the assignment of patients suitable to the level of experience and
capabilities of the nursing staff.
▪ Task assignment, where nursing staff are assigned patient care tasks that are undertaken on
all patients. This model is efficient in the delivery of patient care where there are minimal staff
resources, such as night shifts.
▪ Team nursing, where nursing staff are divided into teams and assigned a group of patients to
undertake all patient care. This model allows for differing skill mix of staff and allows more junior
staff to be directly supervised by more experienced staff.
▪ Case management where nursing staff with particular skills (and competency) or specialties are
assigned patients related to the same specialty. This model provides for specialist care of the
more acutely ill patients and allows staff to specialise in particular clinical areas.
▪ Multi-disciplinary care, where a comprehensive range of services by teams including Cardiac
Surgery Team and Cardiology, nursing staff, allied health professionals and other health
workers. This model provides an inclusive patient care and treatment program.
▪ A combination of the above.
Ideally, the physical environment should permit a range of models of care to be implemented,
allowing flexibility for future change and management preferences.
Levels of Care
The level of care can range from acute specialist nursing care with a progression to intermediate
care and finally self-care with family assistance prior to discharge.

International
Health Facility Guidelines © TAHPI 2024 Page 3
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

ACSU Integrated within a hospital

The Functional Planning Unit referred to as Adult Cardiac Surgery Unit (ACSU) is regarded as a
Coronary Care Unit specifically configured for adult patients requiring Cardiac Surgery.
This Unit will be fully dedicated to Adult Cardiac Surgery and should not be shared with other
patient types or specialties.
ACSU must be supported by other core components which may either be dedicated to Surgery or
shared with other specialties. When these components are shared, ACSU is the link between
them, to manage and coordinate the full journey of the patients before, during and after the
cardiac surgery.
In a facility at RDL 5 or 6 regarded as a Centre of Excellence in Adult Cardiac Surgery, it is
recommended that all core components required to support ACSU be fully dedicated and
exclusive to ACSU. In other facilities, there is no need to duplicate or replicate such shared
components. Instead, the use of such shared facilities for ACSU should be established in the
operational policies, staff training and HIMS software.
The minimum core components required for ACSU are as follows:
▪ Coronary Care Unit (CCU) (the main subject of this FPU)
▪ Cardiac Intensive Care Unit (CICU)
▪ Cardiac Investigation Unit (including Catheterisation Unit)
▪ Operating Unit
▪ Acute Rehabilitation (within ACSU)
The additional supporting components required are as follows:
▪ Sterile Supply Unit
▪ Emergency Unit
▪ Pharmacy Unit
▪ Laboratory Unit
▪ Medical Imaging Unit
▪ Rehabilitation Allied Health Unit (Day Rehabilitation)
▪ Administration Unit
▪ Catering Unit
▪ Linen Handling Unit
▪ Main Entrance Unit
▪ Admission Unit and Discharge
▪ Mortuary General
▪ Housekeeping Unit
▪ Education Unit (for RDL 5 and 6)
▪ Research Facilities (for RDL 6)
Integrated Critical Care
ACSU is part of a broader category of FPU’s referred to as Critical Care. The ideal ACSU will have
back-to-back CICU (Cardiac Intensive Care Unit). This, however, is not mandatory. These two
components as part of the Cardiac Surgery process may be separate but with convenient
connections either horizontally or vertically.
In the model demonstrated in these Guidelines the ACSU is shown back-to-back with CICU as an
integrated unit. This supports maximum efficiency and patient flows and can serve to optimise
staff skills and shared equipment. Also refer to the Unit Planning models below.

International
Health Facility Guidelines © TAHPI 2024 Page 4
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Hot Floor
A comprehensive ‘Hot Floor’ model may include collocation of ACSU, CICU, Catheter Lab and
Operating Unit, as well as parts or all of Medical Imaging on the same floor. The Hot Floor model
has the principal advantage of collocating services, avoiding duplication and with a single
management structure. This allows a more efficient medical and nursing overview and patient
flow.
Advantages of the Hot Floor model include:
▪ Enables standardisation of equipment across the Hot Floor avoiding duplication and minimises
service costs
▪ Assists practitioners particularly medical and nursing to develop expertise in the specialties
▪ Facilitates multi-disciplinary team work and patient case management
The disadvantages of a Hot Floor involve:
▪ Large area required on one floor, which may not be available
▪ The management of a large group of nurses and doctors
▪ Potential infection control risks including cross infection of patients in co-located units
▪ Complications in the flow of visitors
Stand-alone ACSU
A Stand-alone ACSU will be regarded as a Specialised Hospital or designated as a Centre of
Excellence in Adult Cardiac Surgery.
All services and facilities required for a Specialised Hospital according to these Guidelines will be
provided and dedicated to Surgery and Cardiology.
If such a specialised hospital is intended, then all the core and supporting components indicated
above under “ACSU Integrated within a hospital” will be required.
Comprehensive ACSU services
A comprehensive ACSU service will include:
▪ Telemetry beds for monitoring of patients with heart failure or life-threatening arrhythmias
▪ A full range of invasive and non-invasive monitoring
▪ Resuscitation and stabilization of emergencies
▪ Extracorporeal Membrane Oxygenation (ECMO) for unstable patients
▪ A full range of cardiac investigations
▪ 24 hours on call echocardiography, angiography, angioplasty and permanent pacemaker
services
▪ Acute Inpatient as well as Outpatient cardiac rehabilitation programme
▪ Provide Hospital outreach and remote monitoring services
▪ Optional Procedure Room with access for a bed and C-arm
▪ Patient education facilities
▪ ECG (echocardiography)
▪ Cardiac Angiography
▪ Transoesophageal echo (TEE)
▪ Percutaneous Coronary Intervention
▪ Temporary or permanent pacemaker insertion
Bed Numbers and Complement
ACSU total bed numbers required by the facility’s service plan needs to be unitised for effective
management and monitoring. These Units (or pods) should have no more than 12 beds (± 2)

International
Health Facility Guidelines © TAHPI 2024 Page 5
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

each. If more than 14 beds are required, additional units (or pods) can be provided, each with a
staff station and the required support rooms.
In an integrated facility, ACSU is designed back-to-back with CICU. This is the model assumed in
the Functional Relations Diagram and the SOA within these Guidelines.
Bed Types
All beds shall be provided as Single Bedrooms. The current trend is to provide a greater
proportion of single bedrooms, largely for infection control reasons.
The bedrooms should be similar to those required for a Coronary Care Unit with attached ensuite
bathroom. These rooms will have glazing to the corridor and observation from outside the room. If
CICU is integrated back-to-back, the rooms will be fully enclosed as per the ICU guidelines and
standard components.
All single bedrooms can accommodate patients requiring standard contact isolation, but negative
pressure isolation rooms with anteroom should be provided at a ratio of 1 per 8 beds or part
thereof. Positive pressure Isolation rooms are not mandatory and are subject to the clinical
services plan of the hospital.
Unit Planning Models
Depending on the preferred model of care and Role Delineation Level, the ACSU can be designed
under one of the following models:
Model 1- ACSU as a core facility dedicated to Adult Cardiac Surgery with all other components
being independent, catering to different patient types, including Adult Cardiac Surgery.
Advantages of this model include:
▪ May help to avoid bed blockages by allowing a flexible use of all Critical Care facilities
independently
▪ Encourages the development of a greater range of sub-specialty medical and nursing skills

▪ Physical isolation of units that may make staffing more difficult

▪ May lower the focus on the specific needs of Cardiac Surgery patients
Model 2- ACSU directly attached to CICU, with all of them dedicated to Cardiac Surgery with all
other components being independent, catering to different patient types including Cardiac
Surgery.
Advantages of this model include:
▪ Optimization of staff skills, increasing the focus on Cardiac Surgery patients

▪ Duplication of staff within the dedicated CICU and the independent department
Model 3- A dedicated Centre of Excellence in Adult Cardiac Surgery, as a Specialised hospital
with ACSU and all other required components fully dedicated to Adult Cardiac Surgery.
In the Functional Relations Diagram and SOA within these Guidelines, Model 2 is assumed and
shown. However, designers are free to also adopt Models 1 and 3 as long as all the required
components are provided according to the requirements of the individual FPUs within these
Guidelines.
Facility Location
The ACSU should be in a location that eliminates or minimises:
▪ Disturbing sounds (ambulances, traffic, sirens)
▪ Disturbing sights (morgue, cemeteries)
▪ Problems associated with prevailing weather conditions (excessive wind, sun exposure, etc)
Ideally the location should enable expansion if additional beds are required in the future.

International
Health Facility Guidelines © TAHPI 2024 Page 6
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Functional Areas
The ACSU will consist of the following Functional Areas:
▪ Entry/ Reception area (may also be shared area or provided at the Main Entry) with:
-
-
-
-
-
-
-

▪ Patient Areas – areas where patients are accommodated, and facilities specifically intended for
the patient including:
-
-
-
-
-
-

▪ Support Areas – areas used by staff to support the activities of the unit including:
-
-
-
-
-
-

▪ Staff Areas – staff areas that may be shared by two or more Units including:
-
-
-

These Functional Areas are briefly explained below.

Entry/ Reception/ Waiting Areas
As determined by the hospital operating policy, a Reception/ Visitor’s and relatives Waiting areas
shall be provided immediately outside the entry of ACSU, but away from patient and staff traffic
areas, with access to separate male/female toilet facilities and prayer rooms. Waiting areas may
be shared between 2 or 3 Units if they are located adjacent to each other. It is desirable that these
rooms have provision for a drink dispenser, television and comfortable seating. An Interview Room
and a separate area for distressed relatives should be available.
Access to the Unit from the waiting areas should be via visitor Gown-up/ Gown-down rooms.
Patient Areas
Patient Areas will include:

▪ Only single-bed rooms should be provided within ACSU in all new facilities. In existing facilities,
the maximum number of beds per room is 2, but this is not recommended
▪ Each room should have a dedicated ensuite bathroom
▪ Each single-bed room should be designed to accommodate a sofa bed, mobility and walking
aids.

International
Health Facility Guidelines © TAHPI 2024 Page 7
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Ensuites with hand basin, shower and toilet should be provided to all ACSU rooms. If CICU is
integrated back to back, the provision of ensuite bathrooms to CICU is optional but regarded as
desirable.

Procedure Room with access for a bed and C-arm if required; this room is optional and depends
on the service planning and operational policy of each facility.

Support Areas

▪ Staff Station
▪ Handwashing, Linen and Equipment bays
▪ Clean Utility, Dirty Utility and Disposal Rooms
▪ Medication Room
▪ Store room
▪ Beverages Bays and Pantries
▪ Formula preparation and milk storage room
▪ Meeting Room/s and Interview rooms for education sessions, interviews with staff, patient and
families and other meetings
▪ Lab facility – a satellite laboratory within or immediately adjacent to the ACSU must serve this
function. The satellite facilities must be able to provide minimum chemistry and haematology
testing, including arterial blood gas analysis
▪ Biomedical Workshop – a dedicated electronic and pneumatic equipment maintenance service
24 hours on-call emergency service made available
Staff Facilities
Offices/ workstations are required for senior staff in full time administrative roles according to the
approved positions in the Unit. Offices/ workstations for medical staff and some nursing staff
(manager/specialist/registrars/educators) may be located as part of the ACSU.
Ideally administrative areas should be located close to the clinical areas so that the staff always
remain close to the patients.
A Staff Lounge shall be provided within the unit for staff to relax and prepare beverages. A Library/
Reference area with an appropriate range of bench manuals, textbooks and journals for rapid
access 24 hours a day should be available withing the ACSU.
Staff will need close access to the following:
▪ Toilets and Shower;
▪ Lockers; and
▪ Meeting room/s

International
Health Facility Guidelines © TAHPI 2024 Page 8
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Staff Areas, particularly Staff Rooms, Toilets, Showers and Lockers may be shared with adjacent
Units as far as possible. For example an adjacent Inpatient Unit.
Teaching and Clinical Research Facilities
In RDL 5 and 6 the facility includes educational and research activities. Teaching facilities should
allow staff to access simulation training and competency assessment within the unit. These rooms
may also be used by the multidisciplinary team.
A central monitoring station connected to patient cardiac monitors is usually located at the central
staff station. Easy viewing of cardiac rhythm of all patients will encourage discussion between staff
and assist with in-house education. In RDL 5 or 6 facilities, simulation training and competency
assessment facilities may also be provided.
At RDL 6, in association with the provision of all cardiac services for ACSU, research may be
undertaken. Spatial provision for research may be justified by service needs and role delineation.
The following facilities may be required for clinical trials:
▪ Shared offices for senior coordinator/s and research fellow/s
▪ Shared offices/ workstations for other clinical trial research staff
▪ Shared offices/ workstations for registrars and research assistants
▪ Patient consulting room/s (if the unit is accessed by patients)
▪ Drug monitor room
▪ Drugs and research files storage
▪ Research laboratories (wet and dry)

International
Health Facility Guidelines © TAHPI 2024 Page 9
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

3 Functional Relationships
A Functional Relationship can be defined as the correlation between various areas of activity
whose services work together closely to promote the delivery of services that are efficient in terms
of management, cost and human resources. Correct Functional Relationships are identified below:
External
It is necessary that the ACSU has ready access to:
▪ Cardiac Investigation Unit
▪ Cardiac Catheterisation Unit
▪ Emergency Unit- for urgent patient admissions
▪ Operating Unit- for Cardiac Surgery. Note that depending on the clinical decision, post- surgery
patients may be transferred directly to CICU instead of Recovery Stage 1
▪ Medical Imaging Unit- Particularly for chest X-Ray and CT scanning
▪ Nuclear Medicine Unit- PET (if incorporated in the facility)
▪ Main Entrance Unit
▪ Public Amenities Unit
▪ Laboratory Unit- connection via Pneumatic Tube is preferred. This is in addition to the Stat Lab
within ACSU and CICU. The lab should also include a blood bank facility.
▪ Sterile Supply Unit- with connection to the Operating Unit
▪ Pharmacy Unit- for Inpatients and Outpatients. Medication rooms in each unit or pod will be
required.
▪ Biomedical Engineering- to ensure availability and functioning of monitoring and life support
equipment
▪ Rehabilitation- Acute Rehabilitation within the Unit but Post-acute and Day Rehabilitation
outside the Unit (possibly in a separate building or site)
▪ Supply Unit and Housekeeping (either shared or provided as dedicated facilities)
▪ Mortuary Unit
▪ Visitor and Staff car parking
Important and desirable external relationships outlined in the diagram below include:
▪ Separation of visitors arrival from the interior of the ACSU
▪ Outpatient link between the Catheterisation Lab and ACSU
▪ Connection between the Emergency Unit and Catheterisation Lab
▪ Restricted access between ACSU, Operating Unit, and CICU
Internal
Optimal internal relationships should be achieved including the following:
▪ Visitor waiting areas and access to the unit via Gown-up/ Gown-down rooms
▪ Patient occupied areas, forming the core of the ACSU, which require direct access and
observation from the Staff Station
▪ Alternatively, a series of de-centralised Reporting Stations located off the corridor for the
immediate observation of the rooms
▪ Clinical Support Areas such as Utility and storage areas that need to be readily accessible to
both patient and staff work areas
▪ Public/waiting areas located on the perimeter of the unit with access to lifts and circulation
corridors

International
Health Facility Guidelines © TAHPI 2024 Page 10
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

▪ Shared support areas that should be easily accessible from the unit served
Important and desirable internal relationships outlined in the diagram below include:
▪ Staff Station(s) strategically located with supervision and control over the entry corridor and the
patient areas
▪ Key clinical support areas located close to Staff Stations (s) and centralised for ease of staff
access
▪ Administrative areas located in staff accessible corridors
▪ Flows between ACSU, CICU, Operating Unit and Catheterisation Lab to be restricted and
separated from public access
▪ Optionally, Catheterisation Lab to be fully integrated into the Operating Unit

International
Health Facility Guidelines © TAHPI 2024 Page 11
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Functional Relationship Diagram

The Internal and External Functional Relationship are demonstrated in the diagram below.

International
Health Facility Guidelines © TAHPI 2024 Page 12
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

4 Design Considerations
General

Access
External

▪ Ready access from Emergency Unit

▪ Ready access to and from the Operating Unit
▪ Ready access to and from Medical Imaging and Nuclear Medicine Unit
▪ Access from Catheterisation Unit

Internal

▪ Monitor and / or prevent access by visitors depending on the patient’s condition

▪ Advise visitors if patients have been moved or are out of the unit for any reason
▪ Monitor visiting staff and direct them to the appropriate staff member or patient
▪ Monitor patient movements in and out of the unit

Patient Areas
Patient rooms must be situated and designed so that healthcare providers have direct
visualization, with a variety of monitoring at all times. This approach permits the monitoring of
patient status under both routine and emergency circumstances. The ideal design would allow a
direct line of vision between the central Staff Station and the head of the patient.
Where the geometry and the size of the unit does not permit direct observation from the central
staff station, then de-centralised reporting stations should be provided between the rooms with
direct view of the head of the patient through glass panels. Such reporting stations should be
accessed from the corridor rather than inside the room.
To achieve the above observation requirements glazed sliding doors can be fitted to the room wall
against the corridor. The sliding doors should open to provide the minimum clearance for bed
transfer. The sliding doors should operate without a floor track. The glazing of the sliding doors
should be full height so that a patient on the floor can also be seen. The glass in the sliding doors
should be safety glass and have certain markings or frosting to prevent people, including those at
a low level, from running into the glass.
Each such reporting station should have space for two staff positions and two computer screens.
For maximum clarity, the use of camera for patient monitoring as an alternative to direct
observation is not acceptable.
All patient rooms including ACSU, CICU should have individual attached Ensuite bathrooms,
whether the patient is capable of using the bathroom or not. Ensuites cannot be shared between
two rooms.

International
Health Facility Guidelines © TAHPI 2024 Page 13
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Other patient areas directly connected to ACSU, being CICU, should be zonally separated so that
the specialised staff can be allocated accordingly.
Renal Dialysis Facilities
Dialysis machines, including provision for reverse osmosis water and drainage, should be
provided to patient bedrooms according to the Unit’s Operational Policy. As a minimum, dialysis
facilities should be provided in each Isolation Rooms/s, plus one per pod outside the isolation
room. The remaining rooms, as a minimum should have water outlet provided RO water may be
provided via portable dialysis units. Refer to Part E – Engineering Services for details.
Environmental Considerations
Acoustics
The ACSU should be designed to minimize the ambient noise level within the unit and
transmission of sound between patient areas, staff areas and public areas.
Signals from staff call systems, alarms from monitoring equipment, and telephones add to the
sensory overload in critical care units. Without reducing their importance or sense of urgency,
such signals should be modulated to a level that will alert staff members yet be rendered less
intrusive.
For these reasons, floor coverings that absorb sound should be used while keeping infection
control, maintenance, and equipment movement needs under consideration. Walls should be
constructed of material with high sound absorption capabilities. Ceiling soffits and baffles help
reduce echoed sounds. Doorways should be offset, rather than being placed in symmetrically
opposed positions, to reduce sound transmission. Counters, partitions, and glass doors are also
effective in reducing noise levels.
Acoustic treatment will be required to the following:
▪ Patient bedrooms
▪ Interview and meeting rooms
▪ Treatment rooms
▪ Staff rooms/ Changing rooms
▪ Toilets and showers
Natural Light/ Lighting
Natural light and views from the Unit are highly desirable for the staff and patients. As a minimum
50% of the patient rooms should have direct access to external windows. The balance of patient
rooms may have access to borrowed natural light via a glazed corridor or the light filtering through
other rooms with a glazed front.
Natural light and views to the staff and support rooms is desirable but not mandatory.
High quality task lighting is essential to ensure complex medical and pharmacological tasks can
be safely achieved.
Colour corrected lighting is essential to ensure patient assessment can be conducted effectively.
Privacy
The design of ACSU needs to consider the contradictory requirement for staff visibility of patients
while maintaining patient privacy. Unit design and location of staff stations will offer varying
degrees of visibility and privacy.
Each bedroom shall be provided with bed screens to ensure privacy of patients undergoing
treatment in the room. Screens can be provided directly behind the glazed front to the corridor.
Refer to the Standard Components for examples.
Confidentiality for patients during consultation or treatment is a highly important consideration to
be addressed.
External gardens, courtyards or atrium facing bedrooms should be designed in such a way as to
prevent others from looking into bedrooms.

International
Health Facility Guidelines © TAHPI 2024 Page 14
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Interior Décor
Interior décor includes furnishings, style, colour, textures and ambience, influenced by perception
and culture. This can help prevent an institutional atmosphere. However, cleaning, infection
control, fire safety, patient care and the patient’s perceptions of a professional environment should
always be considered.
Some colours, particularly the bold primaries and green, should be avoided in areas where clinical
observation occurs such as bedrooms, treatment areas and corridor. Such colours may prevent
the accurate assessment of skin tones e.g. yellow/ jaundice, blue/ cyanosis, red/ flushing.
Space Standards and Components
Bed Spacing/ Clearances
Bed dimensions become a critical consideration in ascertaining final rooms sizes. The dimensions
noted in these Guidelines are minimum and do not prohibit the use of larger beds where required.
Depending on the operational policy, these spaces should accommodate comfortable furniture for
one or two members/carers without interfering with staff member access to patients.
ACSU patient rooms are all single occupancy and similar in design to CCU rooms. These can also
be identical in design to ICU rooms with the mandatory ensuite bathrooms.
In ACSU bedrooms a minimum of 1200 mm clearance around both sides and the foot of the bed is
required. At the head of the bed, a minimum of 300 mm clearance should be allowed between the
bed and any fixed obstruction or wall. Where possible the bed should float in the centre of the
room rather than pushed against a side wall. This is to allow the staff to move around the bed and
get access to the head of the patient without any interference from obstructions.
Accessibility
The Bedroom and Ensuite should comply with accessibility requirements in accordance with these
Guidelines. Accessible bedrooms and ensuites should enable normal activity for wheelchair
dependent patients, as opposed to patients who are in a wheelchair as a result of their
hospitalisation.
Doors
Door openings to bedrooms shall have a minimum of 1400 mm clear opening to allow for easy
movement of beds and equipment.
Size of the Unit
Nothing in these Guidelines dictates the number of beds in an ACSU. The number of beds shall
be determined by the facility’s service plan. The recommended maximum number of beds per unit
(or pod) is 12 beds (± 2). If more than 14 beds are required, the design should consider additional
units (or pods). Each Unit (or pod) is defined by the requirement to have one set of the supporting
rooms such as the Staff Station, Utility Rooms and Medication Room. However, according to
these guidelines a number of facilities can be shared between the units (or pods) such as staff
amenities, meeting rooms, administration areas and visitor areas.
Safety and Security
The ACSU shall provide a safe and secure environment for patients, staff and visitors, while
remaining a non-threatening and supportive atmosphere conducive to recovery.
The facility, furniture, fittings and equipment must be designed and constructed in such a way that
all users of the facility are not exposed to any possible risks of injury.
Fittings, surfaces, and furniture should have rounded edges and no small/ removable elements. All
cupboards should be provided with locks.
Security issues are important due to the increasing prevalence of violence and threat in health
care facilities.
The arrangement of spaces and zones shall offer a high standard of security through the grouping
of like functions, control over access and egress from the Unit and the provision of optimum
observation for staff. The level of observation and visibility has security implications.
Refer also to Part C – Access, Mobility, OH&S in these Guidelines.

International
Health Facility Guidelines © TAHPI 2024 Page 15
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Drug Storage
Drugs prescribed at the hospital should not be stored in the patient bedroom. Each patient’s
medication shall have a dedicated Medication Room with restricted staff access. Optionally, this
room could either be a Clean Utility room. The use of a Medication Management System is
encouraged but is not mandatory.
In both scenarios, the room must contain:
▪ Benches and shelving
▪ Medications may be manually stored and managed, or alternatively automated Medication
Management systems may be utilised
▪ Lockable cupboards for the manual storage of restricted substances or provision of an
automated Medication Management Systems
▪ Controlled, semi-controlled or narcotic drugs must be kept in a secure cabinet within the
Medication Room with alarm. The room requires controlled staff only access and may include
CCTV surveillance
▪ A refrigerator is required to store restricted substances and must be lockable or housed within
a lockable storage area
▪ The Medication Room must have space for parking a medication trolley
Note: Storage for dangerous and controlled drugs must be in accordance with the relevant
legislation and not stored in a patient bedroom.

Finishes including building fabric, floor, wall and ceiling finishes, should be aesthetic, relaxing and
non-institutional as far as possible. The following additional factors should be considered in the
selection of finishes:
▪ Acoustic properties
▪ Durability
▪ Ease of cleaning
▪ Infection control
▪ Fire safety
▪ Movement of equipment; floor finishes should be resistant to marrying and shearing by wheeled
equipment
In areas where clinical observation is critical, such as bedrooms and treatment areas, lighting and
colours shall be chosen that do not alter the observer’s perception of skin colour.
Walls shall be painted with lead free paint.
Wall protection shall be provided where bed or trolley movement occurs such as corridors,
patient’s bedrooms, equipment and linen storage and treatment areas.

Bedside monitoring equipment should be located to permit easy access and viewing, and should
not interfere with the visualization of, or access to the patient. The bedside nurse and/or monitor
technician must be able to observe the monitored status of each patient at a glance. This goal can
be achieved either by a central monitoring station, or by bedside monitors that permit the
observation of more than one patient simultaneously. Neither of these methods are intended to
replace direct bedside observation.
Weight-bearing surfaces that support the monitoring equipment should be sturdy enough to
withstand high levels of strain over time. Therefore, space and electrical facilities should be
designed accordingly.
Fixture and Fittings

International
Health Facility Guidelines © TAHPI 2024 Page 16
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

In both single and multiple-bed rooms, visual privacy (bed screens) from casual observation by
other patients and visitors shall be provided for each patient. The design for privacy shall not
restrict patient access to the entrance, toilet or shower. The same should also be considered in
single rooms. Bed screens must be cleaned and washed regularly. Select fabric that is waterproof,
fireproof and with antimicrobial properties. Disposable bed screens are another option if it aligns
with the Infection Control Policy of the facility. In isolation rooms or patient rooms used for
quarantine, disposable bed screens could be a more appropriate option than regular bed screens.

Each room shall have partial blackout facilities (blinds or lined curtains) to allow rest during the
daytime. Similar to bed screens, window curtains shall be fireproof, waterproof and be cleaned
often.
Compliance with the Health Authority for the required level of fire resistance should be ensured.
If blinds are to be used instead of curtains, the following will apply:
▪ Vertical or roller blinds are better alternatives than horizontal blinds as horizontal blinds have
more surfaces for collecting dust
▪ Horizontal blinds can be fitted within a double-glazed window assembly with a knob control on
the one side (commonly the bedroom side) or with a dual control (both sides) depending on the
location of the window. This option is preferrable in rooms used for isolation.

Window treatments should be durable and easy to clean. Consideration may be given to use of
double glazing with integral blinds, tinted glass, reflective glass, exterior overhangs or louvers to
control the level of lighting.

An analogue clock/s with a second sweep hand shall be provided and conveniently located for
easy reference from all bed positions and the Staff Station.
Building Services Requirements
Mechanical Services
The unit shall have appropriate air conditioning that allows control of temperature, humidity and air
change. This section identifies unit specific services briefing requirements only and must be read
in conjunction with Part standards applicable.

Unit design should address the following Information Technology/ Communications issues:
▪ Electronic Health Records (EHR) which may form part of the Health Information System (HIS)
▪ Hand-held tablets and other smart devices
▪ Picture Archiving Communications Systems (PACS)
▪ Paging and personal telephones replacing some aspects of call systems/ DECT
▪ Data entry including scripts and investigation requests
▪ Bar coding for supplies and X-rays/ Records
▪ Data and communication outlets, servers and communication room requirements
▪ Wireless network requirements
▪ Videoconferencing requirements
▪ Communications rooms and server requirements
▪ Closed Circuit Television (CCTV) may be required to ensure staff can oversee entry and egress
points

International
Health Facility Guidelines © TAHPI 2024 Page 17
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Patient and Emergency Call facilities shall be provided in all patient areas (e.g. Consult Room/s,
Holding/ Recovery bays, Change Cubicles and Toilets) in order for patients and staff to request for
urgent assistance.
The individual call buttons should be registered and shall alert to an annunciator system.
Annunciator panels should be located in strategic points visible from Staff Stations and audible in
Staff Rooms, Meeting Rooms, and should be of the “non-scrolling” type, allowing all calls to be
displayed at the same time.

Patients may be provided with entertainment/ communications systems according to the

Operational Policy of the facility including:
▪ Television
▪ Telephone
▪ Internet (Wi-Fi) access

The ACSU may include a pneumatic tube station, as determined by the facility Operational Policy.
If provided the station should be located in close proximity to the Staff Station or under direct staff
supervision. When required, a second PTS station may be provided within the medication storage
area.
Requirements include:
▪ The bay should not impede access within staff station areas
▪ Racks should be provided for pneumatic tube canisters
▪ Wall protection should be installed to prevent wall damage from canisters

Warm water supplied to all areas accessed by patients within the Unit should be maintained at
38oC and shall not exceed 43oC. This requirement applies to all staff handwash basins and sinks
in patient accessible areas.
Refer to Part E - Engineering Services for details.

The air temperature in areas should be capable of being maintained along with relative humidity. A
local thermostat in the patient room should be provided from which room temperature can be
adjusted by the occupant.
All HVAC units and systems are to comply with services identified in Standard Components and
Part E – Engineering Services in these Guidelines.

Medical gas is intended for administration to a patient in anaesthesia, therapy, diagnosis or

resuscitation.
Medical gases shall be installed, readily available and dedicated for each patient and they must
not be shared between two patients even in a shared inpatient room.
Oxygen, medical air and suction must be provided to all beds. Medical gases will be provided for
each bed according to the quantities noted in the Standard Components - Room Data Sheets.
Infection Control

consideration the need to ensure

a high level of infection control in all aspects of clinical and non-clinical practice.
Hand Basins
Handwashing facilities shall be required in the corridors, patient bedrooms and other rooms as
specified by the Standard Components.

International
Health Facility Guidelines © TAHPI 2024 Page 18
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Hand-washing facilities shall not impact on minimum corridor widths.

At least one handwashing bay is to be conveniently accessible to the Staff Station. Hand basins
are to comply with Standard Components – “Bay – Hand-washing” and Part D – Infection Control.
Hand basins in patient bedrooms should be used solely for infection control purposes and utilised
only by staff. Patients should use hand basins provided in bathrooms for personal use purposes.
Staff may not use the patient ensuite hand wash basins.
Antiseptic Hand Sanitisers
Antiseptic hand rubs should be located so they are readily available for use at points of care, at
the end of patient beds and in high traffic areas.
The placement of antiseptic hand rubs should be consistent and reliable throughout facilities.
Antiseptic based hand rubs are to comply with Part D – Infection Control, in these guidelines.
Antiseptic Hand Rubs, although very useful and welcome, cannot fully replace Hand Wash Bays.
Isolation Rooms
Negative pressure isolation rooms (Class N) with anteroom should be provided at a ratio of 1 per 8
beds or part thereof.
However, the provision of Positive Pressure isolation rooms (Class P) is optional and will depend
on the clinical assessment and the facility service plan.
Any isolation room may also be used for patients who do not require isolation. However, the Class
N and Class P isolation rooms may not be interchangeable or switchable.
Any room, regardless of the pressure in the room will not be regarded as an isolation room unless
it has an ante-room.
Refer to Part D – Infection Control in these Guidelines.

5 Components of the Unit

Standard Components
Standard Components are typical rooms within a health facility, each represented by a Room Data
Sheet (RDS) and a Room Layout Sheet (RLS). Sometimes, there are more than one configuration
possible and therefore, more than one room layout sheet can be found in the Standard
Components for a room with same function. They may differ in room size and/ or the requirement
of FF and FE items.
The Room Data Sheets are presented in a written format, describing the minimum briefing
requirements of each room type divided into the following categories:
▪ Room Primary Information; includes Briefed Area, Occupancy, Room Description and
relationships, and special room requirements)
▪ Building Fabric and Finishes; identifies the fabric and finish required for the room ceiling, floor,
walls, doors, and glazing requirements
▪ Furniture and Fittings; lists all the fittings and furniture typically located in the room; Furniture
and Fittings are identified with a group number indicating who is responsible for providing the
item according to a widely accepted description as follows:
Group Description
1 Provided and installed by the builder
2 Provided by the Client and installed by the builder
3 Provided and installed by the Client

▪ Building Services; indicates the requirement for communications, power, Heating, Ventilation
and Air conditioning (HVAC), medical gases, nurse/ emergency call and lighting along with
quantities and types where appropriate. Provision of all services items listed is mandatory
▪ Fixtures and Equipment; includes all the services equipment typically located in the room along
the services required such as power, data and hydraulics; Fixtures and Equipment are also

International
Health Facility Guidelines © TAHPI 2024 Page 19
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

identified with a group number as above indicating who is responsible for provision.
The Room Layout Sheets (RLS’s) are indicative plan layouts and elevations illustrating an
example of good design. The RLS indicated are deemed to satisfy these Guidelines. Alternative
layouts and innovative planning shall be deemed to comply with these Guidelines provided that
the following criteria are met:
▪ Compliance with the text of these Guidelines
▪ Minimum floor areas as shown in the schedule of accommodation
▪ Clearances and accessibility around various objects shown or implied
▪ Inclusion of all mandatory items identified in the RDS.
Standard Components have considered the required design parameters described in these
Guidelines. Each FPU should be designed with compliance to Standard Components - Room Data
Sheets and Room Layout Sheets, nominated in the Schedules of Accommodation in Appendices
of this FPU.

International
Health Facility Guidelines © TAHPI 2024 Page 20
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

6 Schedule of Accommodation

International
Health Facility Guidelines © TAHPI 2024 Page 21
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Adult Cardiac Surgery Unit (ACSU)

Standard
ROOM/ SPACE RDL 4 RDL 5/6
Component
Shared Areas
Reception/ Clerical recl-10-d recl-12-d 1 x 12 1 x 12 Shared by all units
Shared by all units; 1.2 m2 per person; 1.5 m2 per
wait-15-d wait-20-d wait-30-
Waiting 1 x 40 1 x 60 wheelchair; If required by local authorities, male/
d similar
female separation to be provided
Meeting Room meet-12-d meet-l-15-d 1 x 15 1 x 15 Shared by all units; Interviews with relatives
Shared by all units; Relative communal space, Modify
Lounge – Relative lnpt-20-i similar 1 x 20 1 x 25
size to suit service
Toilet - Public wcpu-3-d 2 x 3 2 x 3 Shared by all units
Toilet – accessible wcac-6-d 2 x 6 2 x 6 Shared by all units
Gowning Up gwup-d 1 x 12 1 x 12 Dedicated to ACSU only
Gowning Down gwdn-d 1 x 12 1 x 12 Dedicated to ACSU only
Sub Total 133 154
Circulation % 40 40
Area Total 186 216
Patient Areas 8 Rooms 12 Rooms
Provide ceiling mounted lifter in designated bariatric
1 Bedroom - ACSU 1 br-ccu-25-d 7 x 25 11 x 25
room(s)
1 Bedroom – ACSU Isolation Room,
1 br-ccu-25-d similar 1 x 25 2 x 25 Optional dependent on Service Demand
Negative Pressure
Anteroom anrm-d 1 x 6 2 x 6 To negative pressure isolation room if provided
Ensuite - Standard ens-st-d 8 x 5 13 x 5 6 m2 for designated bariatric ensuite(s)
Procedure Room proc-20-d 1 x 20 1 x 20 Optional; provide according to service demand
Sub Total 266 422
Circulation % 40 40
Area Total 372 591

Support Areas
Bay - Beverage, Enclosed bbev-enc-d 1 x 5 1 x 5
Bay - Meal Trolley bmt-4-d 1 x 4 1 x 4 Optional; depends on catering/ operational policies
In addition to basins in patient rooms; 1 at entry, 1
Bay - Handwashing, Type A bhws-a-d 2 x 1 3 x 1
near staff station; Refer to Part D
Bay - Linen blin-d 1 x 2 1 x 2 Quantity and location to suit each facility
Quantity, size dependent on equipment to be stored;
Bay - Mobile Equipment bmeq-4-d 1 x 4 2 x 4
can be opened or enclosed
Optional, Locate at Staff Station or under staff
Bay - Pneumatic Tube bpts-d 1 x 1 1 x 1
supervision
Bay - Resuscitation Trolley bres-d 1 x 2 1 x 2
Clean Utility clur-12-d 1 x 12 1 x 12 May be Interconnected with Medication Room
Medication Room medr-10-d 1 x 10 1 x 10 May be Interconnected with Clean Utility
Cleaner's Room clrm-6-d 1 x 6 1 x 6 May be shared with an adjacent unit in smaller CCUs

International
Health Facility Guidelines © TAHPI 2024 Page 22
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Standard
ROOM/ SPACE RDL 4 RDL 5/6
Component
Communications Room comm-d 1 x 35 1 x 35 If required for engineering design
Dirty Utility dtur-10-d 1 x 10 1 x 10 May be interconnected with Disposal Room
Disposal Room disp-8-d disp-10-d 1 x 10 1 x 10 May be interconnected with Dirty Utility
Gymnasium/ Rehabilitation Exercise gyah-p-d 1 x 24 1 x 30
Exact quantity shall be based on planning geometry.
Observation bay off-wi-1-d similar 4 x 2 6 x 2 Only required if direct observation from staff station is
not possible
Office - Clinical/ Handover off-cln-d 1 x 15 1 x 15
sstn-10-d sstn-14-d sstn-
Staff Station 1 x 14 1 x 20
20-d
stgn-12-d similar stgn-16-d
Store - General 1 x 12 1 x 16 Size as per service demand and operational policies
similar
Store - Equipment steq-15-d or steq-20-d 1 x 15 1 x 20 Size dependent on equipment to be stored
Sub Total 191 221
Circulation % 40 40
Area Total 267 309

Staff Areas
Change – Staff chst-14-d chst-20-d 2 x 14 2 x 20 Separate Male and Female
Meeting Room meet-12-d meet-l-15-d 1 x 15 1 x 15 For Meetings, Tutorials
Office - Single Person, 12 m2 off-s12-d 1 x 12 1 x 12 Unit Manager
Office - Single Person, 12 m2 off-s12-d 1 x 12 1 x 12 Optional for Cardiologist
Office - 2 Person Shared off-2p-d 2 x 12 3 x 12 Optional
Overnight Stay - Bedroom ovbr-10-d 1 x 10 2 x 10
Overnight Stay - Ensuite oves-4-d 1 x 4 2 x 4
Number of lockers depends on staff complement per
Property Bay - Staff prop-2-d prop-3-d 1 x 3 1 x 5
shift,
Staff Room srm-15-d 1 x 15 1 x 20
Toilet - Staff wcst-d 2 x 3 2 x 3 Separate Male and Female
Sub Total 129 174
Circulation % 40 40
Area Total 181 244

Grand Total 1006 1360

International
Health Facility Guidelines © TAHPI 2024 Page 23
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Cardiac Intensive Care Unit (CICU)

ROOM/ SPACE Standard Component RDL 4 RDL 5-6 Remarks
Unit Size Room Codes Qty x m2 Qty x m2
8 beds 12 beds
Entry/ Reception
Gowning Up gwup-d 1 x 12 1 x 12
Gowning Down gwdn-d 1 x 12 1 x 12
Sub Total 24 24
Circulation % 40 40
Area Total 34 34

Intensive Care
1 Bed Room - CICU 1br-icu-25-d 7 x 25 10 x 25
1 Bed Room CICU - Isolation Room,
1br-icu-25-d 1 x 25 2 x 25
Negative Pressure
Anteroom anrm-d 1 x 6 2 x 6 For Isolation Room
Ensuite - Super ens-sp-d 8 x 6 12 x 6 Size for 'full assistance', i.e. 2 staff plus equipment
Procedure Room proc-20-d 1 x 20 1 x 20 Optional
Sub Total 274 404
Circulation % 40 40
Area Total 384 566

Support Areas
Bathroom - Assisted bath-d similar 1 x 15 1 x 15 Optional, inclusion depends on policy of unit
Bay - Beverage bbec-op-d bbev-enc-d 1 x 5 1 x 5
Bay - Blanket/ Fluid Warmer bbw-1-d 1 x 1 1 x 1
Bay - Handwashing, Type A bhws-a-d 2 x 1 3 x 1 At Unit entry and in Corridors; refer to Part D
Bay - Linen blin-d 1 x 2 2 x 2
Bay - Mobile Equipment bmeq-4-d 1 x 4 2 x 4
Bay - Pathology bpath-1-d similar 1 x 3 1 x 3 Point of Care testing
1 Optional, may be located with Pathology Bay or Staff
Bay - Pneumatic Tube bpts-d x 1 1 x 1
Station
As required, may be combined with Bay-
Bay - PPE bppe-d 1 x 1.5 1 x 1.5
Handwashing
Bay - Resuscitation Trolley bres-d 1 x 1.5 2 x 1.5
Cleaner’s Room clrm-6-d 1 x 6 1 x 6
Clean Utility clur-12-d 1 x 12 1 x 12 May be interconnected with Medication room.
Medication Room medr-10-d similar 1 x 10 1 x 10 May be interconnected with Clean Utility room.

International
Health Facility Guidelines © TAHPI 2024 Page 24
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

ROOM/ SPACE Standard Component RDL 4 RDL 5-6 Remarks

Unit Size Room Codes Qty x m2 Qty x m2
8 beds 12 beds
*Optional, if preference is to combine Clean Utility and
Clean Utility/ Medication Room clum-14-d 1 x 14 1 x 14 Medication Room into a single Room, Minimum 14
m2
Dirty Utility dtur-s-10 dtur-12-d 1 x 10 1 x 12 May be interconnected with Disposal Room
Disposal Room disp-8-d 1 x 8 1 x 8 May be interconnected with Dirty Utility
For dismantling & cleaning cots, incubators & other
Equipment Clean-up ecl-10-d similar 1 x 8 1 x 8
equipment but not respiratory equipment
Exact quantity shall be based on planning geometry.
Observation Bay Off-wi-1-d similar 4 x 2 6 x 2 Only required if direct observation from staff station is
not possible
Office - Clinical/ Handover off-cln-d 1 x 15 1 x 15
Office - Write-up (Shared) off-wis-d similar 1 x 12 1 x 12 May be collocated with Staff Station
Respiratory Workroom rewm-d 1 x 20 1 x 20 Inclusion depends on operational policy of unit
Respiratory Store steq-20-d similar 1 x 20 1 x 20 Inclusion depends on operational policy of unit
Staff Station sstn-20-d similar 1 x 18 1 x 20
steq-14-d similar steq-20-d
Store - Equipment 1 x 14 1 x 20
similar
Stgn-12-d similar stgn-16-d
Store - General 1 x 12 1 x 16
similar
Store - Sterile Stock stss-12-d similar 1 x 12 1 x 12
Sub Total 220 247
Circulation % 40 40
Area Total 308 345

Staff Areas
Change - Staff (M/F) chst-12-d similar 2 x 14 2 x 20 Toilet, Shower and Lockers
Office - Single Person off-s12-d 1 x 12 1 x 12 Unit Manager
Office - 2 Person Shared off-2p-d 1 x 12 1 x 12 Staff Specialists
Office - Workstations off-ws-d 2 x 5 3 x 5 Clerical support, Nursing, Medical as required
Overnight Stay Bedroom ovbr-10-d 1 x 10 2 x 10 Optional
Overnight Stay Ensuite oves-4-d 1 x 4 2 x 4 Optional
meet-l-15-d similar meet-l-
Meeting Room 1 x 15 1 x 20 Meetings, Education
20-d similar
Staff Room srm-15-d similar srm-20-d 1 x 15 1 x 20
Sub Total 106 147
Circulation % 40 40
Area Total 149 206

Grand Total 875 1151

International
Health Facility Guidelines © TAHPI 2024 Page 25
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

Please note the following:

▪ Areas noted in Schedules of Accommodation take precedence over all other areas noted in the FPU.
▪ Rooms indicated in the schedule reflect the typical arrangement according to the Role Delineation.
▪ Exact requirements for room quantities and sizes will reflect Key Planning Units identified in the service plan and the policies of the Unit.
▪ Room sizes indicated should be viewed as a minimum requirement; variations are acceptable to reflect the needs of individual Unit.
▪ Office areas are to be provided according to the Unit role delineation and number of endorsed full-time positions in the unit.
▪ Staff and support rooms may be shared between Functional Planning Units dependant on locations and accessibility to each unit and may provide scope to
reduce duplication of facilities.

International
Health Facility Guidelines © TAHPI 2024 Page 26
Part B: Health Facility Briefing & Design
Adult Cardiac Surgery Unit

7 References and Further Reading

In addition to Sections referenced in this FPU, i.e. Part C- Access, Mobility, OH&S, Part D -
Infection Control, and Part E - Engineering Services, readers may find the following helpful:
▪ International Health Facility Guideline (iHFG) www.healthdesign.com.au/ihfg
▪ Guidelines for Design and Construction of Health Care Facilities; The Facility Guidelines
Institute, 2014 Edition; refer to website www.fgiguidelines.org
▪ https: //www.schn.health.nsw.gov.au
▪ Guidelines for the establishment of an Adult Cardiac Surgery Unit (CSU), The Australian and
New Zealand Society of Cardiac and Thoracic Surgeons

International
Health Facility Guidelines © TAHPI 2024 Page 27