A Design Guide to the Healthcare Facilities

Transcription

1 A Design Guide to the Health Care Facilities NFPA 99 Click to edit Master title style Chad Beebe, FASHE, AIA Deputy Executive Director American Society for Healthcare Engineering 1

2 Click to edit Master title style Dave Dagenais, FASHE, CHFM, CHSP Director of Plant Operations Safety Officer Wentworth-Douglass Health System Why NFPA 99 now? Title 42 - Public Health CHAPTER IV - CENTERS FOR MEDICARE &MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES SUBCHAPTER G - STANDARDS AND CERTIFICATION PART CONDITIONS OF PARTICIPATION FOR HOSPITALS 2

3 Who regulates hospitals? Major Regulators 3

4 (c) Adoption of NFPA 99, 2012 Directly adopts NFPA 99: Health Care Facilities Except chapters: Chapter 7 = IT and Nurse Call Chapter 8 = Plumbing Chapter 12 = Emergency Prepare. Chapter 13 = Security How NFPA 99 impacts design Covers more than Med. Gas and Electrical Includes Security, Hyperbaric, Fire Protection, Medical Gas Storage Important ventilation requirements Risk based decisions require multidisciplinary review 4

5 Modifications to other standards Security Requirements Security Vulnerability Assessment (SVA) Medication Storage and Work Areas Infant Abduction Security Behavioral Health Clinical Research Security Communications / Data infrastructure Security Physical Access Control Workplace Violence / Active Shooter 5

6 Medical Gas Requirements Two Chapters: Med Gas Systems Chapter 5 The systems, piping, manifolds and valves Med Gas Equipment Chapter 11 Cylinder Storage Requirements Fire Protection Requirements Defend in Place Defined Stored Electrical Systems (NFPA 111) Compact Mobile Storage rooms Operating Room Fire Protection and Procedures 6

7 Ventilation Smoke Evacuation Can existing systems be decommissioned? Humidity ASHRAE/ASHE/ANSI Standard 170 Addenda Endoscopy positive or negative? NFPA 99 New Format Beginning with 2012 edition of NFPA 99 the format has been changed to risk based and no longer occupancy based 7

8 Why the Change? To provide equal level of safety to patients based on the risk to the patient Create flexibility in the design of healthcare organizations Equalize the cost of codes in comparison to the safety of the patient (put money where the risk is) NFPA 99 Risk Layout Chapters 1-4 Chapters 5-9 Chapters Chapter 12 Chapter 13 Chapter 14 Chapter 15 Administrative items Risk of systems Risk of equipment Risk of emergency management needs Security needs of all healthcare facilities (SVA) Hyperbaric facilities (type of chamber) Features of fire protection for all healthcare facilities 8

9 How the Works Determine what the room or space is used for. Determine the risk to the patient. Select the appropriate risk category. Select the systems or procedures in the code that are prescribed by that level of risk category. Governing Body The person or persons who have the overall legal responsibility for the operation of a health care facility. Many decisions are based on multidisciplinary group that may include Architect / Engineer 9

10 Risk Fundamentals (Chapter 4) Category 1 - Facility systems in which failure of such equipment or system is likely to cause major injury or death of patients or caregivers shall be designed to meet system Category 1 requirements as defined in this code. 10

11 Fundamentals (Chapter 4) Category 2 - Facility systems in which failure of such equipment is likely to cause minor injury to patients or caregivers shall be designed to meet system Category 2 requirements as defined in this code. Fundamentals (Chapter 4) Category 3 - Facility systems in which failure of such equipment is not likely to cause injury to the patients or caregivers, but can cause patient discomfort shall be designed to meet system Category 3 requirements as defined in this code. 11

12 Fundamentals (Chapter 4) Category 4 -Facility systems in which failure of such equipment would have no impact on patient care shall be designed to meet system Category 4 requirements as defined in this code. Fundamentals (Chapter 4) The risk categories of chapter 4 shall apply to chapter Chapter 12 contains it own categories Chapters apply to all without different categories. 12

13 Fundamentals (Chapter 4) 4.2* Risk Assessment. Categories shall be determined by following and documenting a defined risk assessment procedure. A.4.2 Risk assessment should follow procedures such as those outlined in ISO 31010, NFPA 551, SEMI S or other formal process. The results of the assessment procedure should be documented and records retained. Impact on Design 13

14 Operating Room Suites OR 1 Minor Procedure Room OR 2 OR Indicates Space in the room Soiled Storage OR Storage OR 4 OR 6 OR Workroom OR 5 Emergency Room Suites Indicates Space in the room 1 2 ED Holding Room Trauma X-Ray Trauma 4 Trauma 3 Trauma Trauma 2 1 Decon Room GYN Nurse Station ED 1 ED 2 ED 6 ED 5 ED 4 ED 3 Isolation Room BH2 BH1 Reception Waiting Room 14

15 Nursing Floor ICU 4 Urgent Care Center 15

16 Same Day Surgery Medical Office Building 16

17 Imaging Center Radiation Oncology Center 17

18 Resources