2018 Guidelines Update: Changes to Keep Pace with Clinical Practices
Douglas S. Erickson, FASHE, CHFM, HFDP, CHC, Chair, 2010, 2014, and 2018 Health Guidelines Revision Committee (HGRC), and Dana Swenson, PE, MBA, UMass Memorial Health Care System
This webinar begins with a discussion of what “minimum standards” means, the consensus process used to develop the Guidelines documents, and the Facility Guidelines Institute’s new Beyond Fundamentals program, which offers draft design requirements as well as more in-depth information for applying Guidelines requirements or going beyond them. In the second half, the presenters will address new text, including accommodations for care of patients of size, accommodations for telemedicine services, and a revised chapter on mobile/transportable medical units, and summarize changes to requirements for recovery spaces; imaging, examination, procedure, and operating rooms; and sterile processing facilities.
Use of the Guidelines for Design and Construction: An Architect’s, an Owner’s, and an AHJ’s Perspective
Kirsten Waltz, AIA, ACHA, EDAC, LEED AP, SmithGroup; Wade Rudolph, MBA, CHFM, Mayo Clinic Health System; and John Williams, Washington State Department of Health
The FGI Guidelines documents contain minimum requirements for design and construction of health and residential care facilities. This presentation will help viewers understand how to apply these requirements as minimum requirements, a starting point for more expanded designs where needed, and a base for regulatory review of facility plans. Choosing the approach appropriate for each project will help designers and care organizations provide facilities that support today’s clinical and residential care practices and offer a safe environment for patients or residents and staff.
Breaking Bad: Improving Resident-Centered Regulations
Jane Rohde, AIA, FIIDA, ASID, ACHA, CHID, LEED AP BD+C, GGA-EB, and Steve Lindsey, MSW, Garden Spot Village
The long-term care industry in the United States has shifted toward provision of person-centered care in a more home-like environment. However, outdated and obsolete regulations, standards, and codes have been a barrier to creating built environments that support person-centered care. To respond to this deficiency, the minimum requirements in the Facility Guidelines Institute’s 2018 Guidelines for Design and Construction of Residential Health, Care, and Support Facilities have been updated to support and promote the provision of person-centered care. This webinar also reviews these updates, including more about the resident safety risk assessment, requirements for two new facility types included in this edition (substance abuse treatment centers and settings for individuals with intellectual and/or developmental disabilities), and clarification of HVAC requirements for all facility types.
Appropriate Room Use - Part 1: Exam, Procedure, and Operating Rooms
Bryan Langlands, AIA, ACHA, EDAC, LEED GA, NBBJ, and David Shapiro, MD, CHC, CHCQM, CHPRM, LHRM, CASC, Red Hills Surgical Center
This is the first of a two-part webinar intended to clarify when to apply the FGI Guidelines requirements for exam, procedure, operating, and imaging rooms. There’s much confusion as to what’s required to support anesthesia equipment in procedure and operating rooms, including when anesthesia is needed and what infrastructure is required when anesthesia is applied by patient type rather than procedure type. As a result, procedures are sometimes performed in spaces that may not support the level of intervention involved. FGI’s 2018 Health Guidelines Revision Committee made a concerted effort to align the definition and application of requirements for the various room types where procedures take place. This realignment was based on the level of invasiveness of the procedure and perceived level of risk to the patient. This webinar will help health care designers determine when a procedure or operating room is required and how to apply new clearances to support anesthesia equipment when it is used in these rooms.
Appropriate Room Use — Part 2: Imaging Room Classifications
Tobias Gilk, MRSO, MRSE (MRSCTM), MArch, RAD Planning, and Bryan Langlands, AIA, ACHA, EDAC, LEED GA, NBBJ
This is the second part of a two-part webinar intended to clarify when to apply the FGI Guidelines requirements for exam, procedure, operating, and imaging rooms. The 2018 Health Guidelines Revision Committee created a new imaging classification system that provides basic imaging room requirements, with additional details for specific modalities, with the goal of making imaging room design more easily adaptable to new technologies. This webinar will help designers determine when a Class 1 (diagnostic), Class 2 (equivalent to a procedure room), or Class 3 (equivalent to an operating room) imaging room is required. Clearances required around the imaging equipment and patient position are also reviewed.
Pod People: Low-Acuity Patient Treatment Stations in the ED
Bryan Langlands, AIA, ACHA, EDAC, LEED GA, NBBJ, and Christine Carr, MD, FACEP, Medical University of South Carolina
Across the United States, providers in overcrowded emergency departments (EDs) are forced to treat low-acuity vertical patients in makeshift treatment spaces (e.g., open waiting areas and hallways) that do not meet minimum standards for space, acoustics, or privacy. Health care organizations are looking for ways to manage these low-acuity patients and improve turnaround times and patient satisfaction scores for all patients.
This webinar will review the challenges of innovating in the ED design arena and introduce new concepts to be proposed for the 2022 edition of the FGI Guidelines. Low-acuity patients (ESI Levels 5, 4, and some ESI Level 3) often require only a chair or recliner and could receive treatment in smaller, appropriately sized stations that include all necessary medical utilities. Presently, AHJs have no guidance for regulating these spaces as there is no provision for low-acuity care stations in the Guidelines; the draft 2022 language intended to remedy this will be discussed along with the split flow concept of ED traffic that it supports.
Flexible Application of the Outpatient Guidelines
John L. Williams, Washington State Department of Health, and Kirsten Waltz, AIA, ACHA, EDAC, LEED AP, SmithGroup
The new Guidelines for Design and Construction of Outpatient Facilities was developed to meet the needs of the health care industry as new treatments are performed in new locations, traditional inpatient services move to outpatient settings, and new practices and facility types emerge. The idea is to create flexible facilities that can readily be reused for newer procedures, technologies, or purposes in the future. The presenters will discuss two approaches to applying the Outpatient Guidelines requirements—one for facility types detailed in the document and the other for facility types that have requirements scattered in multiple chapters. Several case studies are presented to demonstrate using the Guidelines to design different outpatient facility types.
The Functional Program and Safety Risk Assessment: How to Create and Apply Them
Kenneth N. Cates, SASHE, Northstar Management Company; and Ellen Taylor, PhD, AIA, MBA, EDAC, The Center for Health Design
Development of a functional program is an important first step in health and residential care design that allows a provider organization to assess its priorities and develop direction for the design team. A safety risk assessment is begun during project planning and should evolve throughout design, construction, and commissioning; this attention to the many aspects of safety in health and residential care facilities yields facilities that support safe patient care and encourage staff retention. This webinar reviews the process and uses for both a functional program and a safety risk assessment.
Accommodations for Care of Patients of Size
Mary W. Matz, MSPH, CPE, CSPHP, Patient Care Ergonomic Solutions, and Joseph J. Strauss, AIA, ACHA, Cleveland Clinic
Statistics show that more than three-quarters of Americans are overweight. Hospitals must be able to accommodate these individuals safely, protecting both the patients and the staff who care for them. Outpatient facilities may be able to limit the type of patients they serve. In either case, a decision should be made for each project as to whether accommodations for patients of size will be provided and, if so, what percentage of a facility will incorporate these elements. For the 2018 FGI Guidelines, the Health Guidelines Revision Committee made a concerted effort to provide guidance to health care organizations attempting to make these determinations. From considerations during planning to ensuring enough space is provided for these patients and the caregivers assisting them, both recommendations and specific requirements are provided.
Sterile Processing Department: Design and HVAC Considerations
Byron Burlingame, MS, RN, BSN, CNOR, Association of periOperative Registered Nurses, and Paula Wright, RN, BSN, CIC, Massachusetts General Hospital
Sterile processing facility requirements have been significantly revised in the 2018 Guidelines for Design and Construction hospital and outpatient facility documents. Expanded guidance is provided for designing these critical areas to support and encourage clinical personnel to comply with current professional practice guidelines for cleaning, decontaminating, and sterilizing surgical instruments. The presenters will also discuss when a two-room sterile processing facility is required and when a single-room sterile processing facility is acceptable as well as ventilation requirements to support a dirty-to-clean workflow.