Contents. Preface Acknowledgments About the Guidelines Major Additions and Revisions Glossary List of Acronyms. Part 1 General 1.

Transcription

1 Contents Preface Acknowledgments About the Guidelines Major Additions and Revisions Glossary List of Acronyms xi xiii xxi xxv xxix xxxv Part 1 General Introduction General Application Minimum Standards for New Facilities and Major Revisions New Construction Renovation General Facilities Subject to Compliance with the Guidelines Undiminished Safety Long-Range Improvement Government Regulations Design Standards for Accessibility Regulations for Earthquake-Resistant Design for New Buildings Flood Projection National Standards for the Protection of Patient Health Information Environmental Regulations Building Codes and Standards Safe Environment Code Compliance Equivalency Concepts English/Metric Measurements Codes, Standards, and Other Documents Referenced in the Guidelines Planning, Design, Construction, and Commissioning General Application Multidisciplinary Project Team Environment of Care and Facility Function Considerations Functional Program General Functional Program Content Space Program Safety Risk Assessment General Infection Control Risk Assessment Patient Handling and Movement Assessment Fall Prevention Assessment Medication Safety Assessment Behavioral and Mental Health Risk Assessment Patient Immobility Assessment Security Risk Assessment Environment of Care Requirements Delivery of Care Model Concepts Patient, Visitors, Physicians, and Staff Accommodation and Flow Building Infrastructure and Systems Design Physical Environment Elements Planning and Design Considerations and Requirements Acoustic Design Sustainable Design Wayfinding Design Considerations for Accommodation of Patients of Size Emergency Preparedness and Management Renovation Phasing Isolation Maintenance of Air Quality and Utilities Existing Conditions Commissioning Commissioning Requirements Commissioning Activities Commissioning Agent vii

2 1.2-9 Record Drawings and Manuals Drawings Equipment Manuals Design Data 1.3 Site General Application Location Availability of Transportation Security Availability of Utilities Site Features Signage Lighting Roads and Walkways Parking Emergency Access Landscape Design Features Transfer Support Features Environmental Pollution Control Equipment General Application Equipment List Documentation Requirements Equipment Classification Equipment Requirements Major Technical Equipment Electronic Equipment Space Requirements for Equipment Fixed and Building Service Equipment Movable Equipment Part 2 Hospital Facility Types Common Elements for Hospitals General Application Functional Program Site Patient Care Units and Other Patient Care Areas General Patient Room Accommodations for Care of Patients of Size Special Patient Care Rooms Reserved Support Areas for Patient Care Units and Other Patient Care Areas Support Areas for Staff Support Areas for Families, Patients, and/or Visitors Diagnostic and Treatment Areas Reserved Examination Room or Emergency Department Treatment Room Accommodations for Telemedicine Services Pre- and Post-Procedure Patient Care Patient Support Facilities Laboratory Services Pharmacy Services Food and Nutrition Services General Support Facilities Sterile Processing Linen Services Materials Management Waste Management Environmental Services Engineering and Maintenance Services Morgue Services Public and Administrative Areas General Public Areas Administrative Areas Support Areas for Staff and Volunteers Design and Construction Requirements Reserved Architectural Details, Surfaces, and Furnishings Building Systems General Heating, Ventilation, and Air-Conditioning Systems Electrical Systems Plumbing Systems Communications Systems Electronic Safety and Security Systems Special Systems 2.2 Specific Requirements for General Hospitals General Application Patient Care Units General Medical/Surgical Patient Care Unit Oncology Patient Care Unit Pediatric and Adolescent Oncology Patient Care Unit Intermediate Care Unit Critical Care Unit Pediatric Critical Care Unit Neonatal Intensive Care Unit Obstetrical Unit Nursery Unit viii

3 Pediatric and Adolescent Patient Care Unit Psychiatric Patient Care Unit In-Hospital Skilled Nursing Patient Care Unit Bariatric Patient Care Unit Diagnostic and Treatment Facilities Emergency Services Observation Unit Surgical Services Imaging Services Radiation Therapy Reserved Rehabilitation Therapy Respiratory Therapy Renal Dialysis Services (Acute and Chronic) Endoscopy Services Cancer Treatment/Infusion Therapy Hyperbaric Suite Patient Support Facilities Laboratory Services Pharmacy Services Food and Nutrition Services General Support Facilities Sterile Processing Linen Services Materials Management Waste Management Environmental Services Engineering and Maintenance Services Morgue Services Public and Administrative Areas Design and Construction Requirements Building Systems Reserved Heating, Ventilation, and Electrical Systems Plumbing Systems Communications Systems Electronic Safety and Security Systems Special Systems 2.3 Specific Requirements for Freestanding Emergency Care Facilities General Application Reserved Diagnostic and Treatment Areas General Reception and Triage Area Communications with EMS Treatment Room or Area Special Patient Care Areas Imaging Services Reserved Support Areas for the Freestanding Emergency Care Facility Support Areas for Staff Support Areas for Patients Patient Support Facilities Laboratory Services Pharmacy Services Food and Nutrition Services General Support Facilities Sterile Processing Linen Services Materials Management Waste Management Environmental Services Engineering and Maintenance Services Public and Administrative Areas General Public Areas Administrative Areas Design and Construction Requirements Building Systems Specific Requirements for Critical Access Hospitals General Application Functional Program Site Patient Care Units General Critical Access Patient Care Unit Reserved General Psychiatric Patient Care Unit Child Psychiatric Unit Alzheimer s and Other Dementia Unit Forensic Psychiatric Unit Swing Beds Diagnostic and Treatment Areas General Emergency Services Surgical Services Imaging Services Telemedicine Services Mobile/Transportable Medical Units Patient Support Facilities Laboratory Services Pharmacy Food and Nutrition Services General Support Facilities Sterile Processing ix

4 Linen Services Materials Management Waste Management Environmental Services Engineering and Maintenance Services Public and Administrative Areas Design and Construction Requirements Reserved Architectural Details, Surfaces, and Furnishings Building Systems General Heating, Ventilation, and Electrical Systems Plumbing Systems Communications Systems Electronic Safety and Security Systems 2.5 Specific Requirements for Psychiatric Hospitals General Application Reserved Site Shared Services Environment of Care Patient Care Units General General Psychiatric Patient Care Unit Child Psychiatric Patient Care Unit Alzheimer s and Other Dementia Patient Care Unit Forensic Psychiatric Patient Care Unit Diagnostic and Treatment Areas Examination Room Imaging Services Rehabilitation Therapy Electroconvulsive Therapy Patient Support Facilities Laboratory Services Pharmacy Services Food and Nutrition Services General Support Facilities Sterile Processing Linen Services Materials Management Waste Management Environmental Services Engineering and Maintenance Services Public and Administrative Areas Design and Construction Requirements Reserved Architectural Details, Surfaces, and Furnishings Building Systems General Reserved Electrical Systems Plumbing Systems Communications Systems Electronic Safety and Security Systems Special Systems 2.6 Specific Requirements for Rehabilitation Hospitals General Application Patient Care Units and Living Areas General Rehabilitation Patient Care Unit Patient Living Areas Diagnostic and Treatment Locations Rehabilitation Therapy Optional Units Patient Support Facilities Laboratory Services Pharmacy Services Food and Nutrition Services General Support Facilities Reserved Linen Services Materials Management Waste Management Environmental Services Engineering and Maintenance Services Public and Administrative Areas Design and Construction Requirements Building Systems Reserved Heating, Ventilation, and Electrical Systems Plumbing Systems Communications Systems Electronic Safety and Security Systems Special Systems 2.7 Specific Requirements for Children s Hospitals General Application Reserved Site x

5 2.7-2 Patient Care Units General Pediatric Medical/Surgical Patient Care Unit Oncology Patient Care Unit Reserved Pediatric Critical Care Pediatric Cardiac Critical Care Unit Neonatal Intensive Care Unit Obstetrical Unit Nursery Unit Reserved Pediatric Psychiatric Patient Care Unit Reserved Pediatric Bariatric Patient Care Unit Diagnostic and Treatment Areas Emergency Services Observation Unit Surgical Services Imaging Services Radiation Therapy Rehabilitation Therapy Respiratory Therapy Reserved Renal Dialysis Endoscopy Cancer Treatment/Infusion Therapy Hyperbaric Suite Patient Support Facilities Laboratory Services Pharmacy Services Food and Nutrition Services General Support Facilities Sterile Processing Linen Services Materials Management Waste Management Environmental Services Engineering and Maintenance Services Public and Administrative Areas General Public Areas Administrative Areas Design and Construction Requirements Building Systems Specific Requirements for Mobile/Transportable Medical Units General Application Reserved Site Reserved Diagnostic and Treatment Locations Mobile/Transportable Units Pre- and Post-Procedure Patient Care Areas Reserved Support Areas for Mobile/Transportable Medical Units Reserved Support Areas for Patients Reserved Reserved Public and Administrative Areas General Public Areas Design and Construction Requirements Reserved Architectural Details and Surfaces for Unit Construction Building Systems Reserved Heating, Ventilation, and Electrical Systems Plumbing Systems Communications Systems Safety and Security Systems Part 3 Ventilation of Hospitals 281 ANSI/ASHRAE/ASHE Standard : Ventilation of Health Care Facilities 238 Index 327 xi

6 List of Tables Part 1 Table 1.2-1: Safety Risk Assessment (SRA) Components 46 Table 1.2-2: Infection Control Risk Assessment Design Considerations 48 Table 1.2-3: Categorization of Hospital Sites by Exterior Ambient Sound with Design Criteria for Sound Isolation of Exterior Shell in New Construction 49 Table 1.2-4: Minimum Design Room-Average Sound Absorption Coefficients 51 Table 1.2-5: Maximum Design Criteria for Noise in Interior Spaces Caused by Building Systems 52 Table 1.2-6: Design Criteria for Minimum Sound Isolation Performance Between Enclosed Rooms 53 Table 1.2-7: Design Criteria for Speech Privacy for Enclosed Rooms and Open-Plan Spaces 54 Table 1.2-8: Maximum Limits on Floor Vibration Caused by Footfalls in Hospitals 55 Appendix Table A1.2-a: Safety Risk Assessment Team Member Expertise 47 Appendix Table A1.2-b: Approximate Distance of Noise Sources for Use in Categorization of Hospitals by Exterior Ambient Sound 50 Part 2 Table 2.1-1: Electrical Receptacles for Patient Care Areas in Hospitals 129 Table 2.1-2: Locations for Nurse Call Devices in Hospitals 131 Table 2.1-3: Station Outlets for Oxygen, Vacuum (Suction), Medical Air, and Instrument Air Systems in Hospitals 133 Table 2.1-4: Hot Water Use General Hospital 135 Table 2.2-1: Examination/Treatment, Procedure, and Operating Room Classification 218 Table 2.2-2: Classification of Room Types for Imaging Services 219 Appendix Table A2.1-a: Maximum Length of Hot Water System Pipe or Tube 136 Appendix Table A2.2-a: Sound Transmission Loss or Attenuation Through Horizontal and Vertical Barriers in NICUs 220 xii