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    Guidelines

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    z3cyber
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    © All Rights Reserved
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    RAdeq? ver WATS GUIDELINES FOR DESIGN AND CONSTRUCTION OF ~ HOSPITAL AND HEALTH CARE FACILITIES SO os => The American Institute of Architects Press 1735 New York Avenue, N.W. Washington, D.C. 20006 Compilation °1996 by The American Institute of Architects Al rights reserved Printed in the United States ‘Second impression 1998, ISBN 1-55835-151-5 TS Preface ‘Major Additions and Revisions Acknowledgments 1, Introduction Ll General 1.2 Renovation 1.3 Design Standards for the Disabled 14 Provisions for Disasters, 1.5. Codes and Standards 2, Energy Conservation 21 General Sit 3.1 Location 3.2 Facility Site Design 3.3 Environmental Pollution Control 4. Equipment 4.1 General 4.2 Classification 4.3. Major Technical Equipment 4.4 Equipment Shown on Drawings 45 Electronic Equipment 5. Construction 5.1 Planning and Design 52 Phasing 53. Commissioning 5.4 Nonconforming Conditions 6. Record Drawings and Manuals 6.1 Drawings 62 Equipment Manuals 63 Design Data 7. General Hospital 71 General Considerations 7.2 Nursing Unit (Medical and Surgical) 73° Critical Care Units 7A Newborn Nurseries 75 Pediatric and Adolescent Unit 7.6 Psychiatric Nursing Unit 10 10 10 10 nl u n n 2 4 18 9 a 18 19 7:10 7 712 113 74 TAS 716 77 718 7119 720 721 722 723 724 125 7.26 12 78 729 730 731 732 81 82 83 84 85 86 87 88 89 8.10 ul 812 813 814 8.15 8.16 8.17 8.18 8.19 8.20 821 822 823 824 825 8.26 827 8.28 ‘Surgical Suites Obstetrical Faci Emergency Service Imaging Suite ‘Nuclear Medicine Laboratory Suite Rehabilitation Therapy Department Renal Dialysis Unit (Acute and Chronic) Respiratory Therapy Service Morgue Pharmacy Functional Elements ‘Administration and Public Areas Medical Records Central Services General Stores Linen Services Facilities for Cleaning and Sani Employee Facilities Housekeeping Rooms Engineering Service and Equipment Areas General Standards for Details and Finishes Design and Construction, Including. Fire-Resistant Standards Special Systems ‘Mechanical Standards Electrical Standards s ing Carts Nursing Facilities General Conditions Resident Unit Resident Support Areas Activities Rehabilitation Therapy Personal Services (Barber/Beauty) Areas Subacute Care Facilities ‘Alzheimer’s and Other Dementia Units Dietary Facilities ‘Administrative and Public Areas Linen Services Housekeeping Rooms Engineering Service and Equipment Areas General Standards for Details and Finishes Finishes Construction Features Reserved Reserved Reserved Reserved Reserved Reserved Reserved Reserved Reserved Reserved Reserved Reserved SSSSSAIGARAARARAALLIS SSSSss 8.29 Reserved 8.30 Special Systems 8.31 Mechanical Standards 8.32 Electrical Standards 9. Outpatient Facilities 9.1 General 9.2 Common Elements for Outpatient Facilities 93 Primary Care Outpatient Facilities 94 Small Primary (Neighborhood) ‘Outpatient Facility 95 Outpatient Surgical Facility 9.6 Freestanding Emergency Facility 9.7 Freestanding Birthing Facility 9.8 Freestanding Outpatient Diagnostic and Treatment Facility 9.9. Endoscopy Suite 9.10 Cough-Inducing and Aerosol-Generating. Procedures. 9.11 Reserved 9.12 Reserved 9.13 Reserved 9.14 Reserved 9.15 Reserved 9.16 Reserved 9.17 Reserved 9.18 Reserved 9.19 Reserved 9.20 Reserved 9.21 Reserved 9.22. Reserved 9.23 Reserved 9.24 Reserved 9.25. Reserved 9.26 Reserved 9.27 Reserved 9.28 Reserved 9.29 Reserved 930 Special Systems 931 Mechanical Standards 9.32 Electrical Standards 10, Rehabilitation Facilities 10.1 General Considerations 10.2 Evaluation Unit 10.3 Psychological Services Unit 10.4 Social Services Unit 10.5 Vocational Services Unit 10.6 Dining, Recreation, and Day Spaces 10.7 Dietary Department 10.8 Personal Care Unit for Inpatients 10.9 Activities for Daily Living Unit 10.10 Administration and Public Areas 10.11 Engineering Service and Equipment Areas 10.12 Linen Services 10.13 Housekeeping Room(s) Cc 6 10 n 98 98 98 99 99 99 99 100 100 100 100 101 101 10.14 Employee Facilities 10.15 Nursing Unit (for Inpatients) 10.16 Sterilizing Facilities 10.17 Physical Therapy Unit 10.18 Occupational Therapy Unit 10.19 Prosthetics and Orthotics Unit 10.20 Speech and Hearing Unit 10.21 Dental Unit 10.22 Imaging Suite 10.23 Pharmacy Unit 10.24 Details and Finishes 10.25 Design and Construction, Including Fire-Resistant Standards 10.26 Reserved 10.27 Reserved 10.28 Reserved 10.29 Reserved 10.30 Special Systems 10.31 Mechanical Standards 10.32 Electrical Standards A. Psychiatric Hospital 11.1 General Conditions 11.2 General Psychiatric Nursing Unit 11.3. Child Psychiatric Unit 11.4. Geriatric, Alzheimer’s, and Other Dementia Unit 11.5. Forensic Psychiatric Unit 11.6 Radiology Sui 11.7 Nuclear Medicine 118. Laboratory Suite 11.9 Rehabilitation Therapy Department 11.10 Pharmacy 11.11 Dietary Facilities 11.12 Administration and Public Areas 11.13 Medical Records 11.14 Central Services 11.15 General Storage 11.16 Linen Services 11.17 Facilities for Cleaning and Sanitizing Carts 11.18 Employee Facilities 11.19 Housekeeping Room 11.20 Engineering Service and Equipment Area 11.21 Waste Processing Services 11.22 General Standards for Details and Finishes 11.23 Design and Construction, Including. Fire-Resistant Standards 11.24 Reserved 11.25 Reserved 11.26 Reserved 11.27 Reserved 11.28 Reserved 11.29 Reserved 11.30 Special Systems 11.31 Mechanical Standards 11,32 Electrical Standards 101 101 103 103 103 103 103 103 104 104 104 106 106 106 106 106 106 107 Tt 3 na 6 16 16 116 7 uy 17 18 us us ns 18 18 119 9 119 n9 19 n9 9 9 119 9 9 19 19 19 19 120 124 12. Mobile, Transportable, and Relocatable Units 12.1 General 122. Reserved 123. Reserved 124 Reserved 125. Reserved 126 Reserved 12.7. Reserved 129 Reserved 129. Reserved 12.10 Reserved 12.11 Reserved 12.12 Reserved 12.13 Reserved 12.14 Reserved 12.15 Reserved 12.16 Reserved 12.17 Reserved 12.18 Reserved 12.19 Reserved 12.20 Reserved 12.21 Reserved 12.22 Reserved 12.23 Reserved 12.24 Reserved 12.25 Reserved 12.26 Reserved 12.27 Reserved 12.28 Reserved 12.29 Reserved 12.30 Reserved 12.31 Mechanical Standards 12.32 Blectrical Standards 13. Hospice Care Appendix A. 128 128 128 128 128 128 128 128 128 128 128 128 128 128 129 129 129 129 129 129 129 129 129 129 129 129 129 129 129 129 129 BL 132 Tables - Sound Transmission Limitations in General Hospitals . Ventilation Requirements for Areas Affecting Patient Care in Hospitals and Outpatient Facilities 10. nL. and Air Conditioning Systems in General Hospitals Hot Water Use—General Hospital Station Outlets for Oxygen, Vacuum (Suction), and Medical Air Systems Pressure Relationships and Ventilation of Certain Areas of Nursing Facil Filter Efficiencies for Central Ventilation and Air Conditioning. Systems in Nursing Facilities 3. Hot Water Use—Nursing Facilities ). Flame-Spread and Smoke-Reduction Limitations on Interior Finishes Filter Efficiencies for Central Ventilation and Air Conditioning, ‘Systems in Outpatient Facilities Filter Efficiencies for Central Ventilation and Air Conditioning. ‘Systems in Psychiatric Hospitals 37 58 a 4 16 16 125 ‘This isthe latest in a 45-year series of guidelines to aid in the design and construction of hospital and medical facilities, ‘The original General Standards appeared in the Federal Register on February 14, 1947, as part of the implement- ing regulations for the Hill-Burton program. The stan- dards were revised from time to time as needed. In 1973, the document was retitled Minimum Requirements of Construction and Equipment for Medical Facilities to ‘emphasize that the requirements were generally mini- ‘mum, rather than recommendations of ideal standards. Sections 603(b) and 16202) of the Public Health Service ‘Act require the Secretary of the Department of Health ‘and Human Services (HHS) to prescribe by regulation general standards of construction, renovation, and equip- ‘ment for projects assisted under Title VI and Title XVI, respectively, ofthe act. Since Title VI and Title XVI ‘grant and loan authorities have expired, there is no need, to retain the standards in regulation, In 1984, HHS removed from regulation the requirements relating to minimum standards of construction, renova- tion, and equipment of hospitals and other medical facili- ties, as cited in the Minimum Requirements, DHEW Publication No. (HRA) 81-14500. To reflect the nonreg~ tlatory status, the title was changed to Guidelines for Construction and Equipment of Hospital and Medical Facilities, For this 1996-97 edition, the title has been amended to read Guidelines for Design and Construction of Hospital and Health Care Facilities to reflect the scope, content, and usage of this document. ‘These Guidelines are evolving in order to provide gui ance to providers, designers, and regulators in a continu- ally changing environment. It is recognized that many health care services may be provided in facilities not subject to licensure or regulation, and itis intended that these Guidelines be suitable for use by ll health care providers, Its further intended that, when used as regu- Preface lations, some latitude be granted in complying with these Guidelines, so long as the health and safety of the occu- pants ofthe facility are not compromised. ‘The Guidelines will be used by HHS to assess Depart- ‘ment of Housing and Urban Development Section 242 applications for hospital mortgage insurance and the Indian Health Service construction projects. The Guide lines may also be used by other entities, such as state licensure agencies. For tis reason, regulatory language was retained. The 1996-97 edition of the Guidelines fol- lows these principles. Explanatory and guide material is included in appendix A, which is not mandatory. ‘The Health Care Finance Administration (HCFA) and the Health Resources Services Administration (HRSA), ‘which are both in the Department of Health and Human Services, are supporting the efforts of the 1996-97 Guidelines both financially and with support staff. HCFA, thas the responsibility for the reimbursement and opera- tion of the Medicare and Medicaid programs. Hospital ‘construction and costs are directly related to the charge of HCFA’s mission. Although HCFA is not adopting the Guidelines as regulations, the agency does concur with the design and construction recommendations. ‘This edition of the Guidelines reflects the work of advi- sory groups from private, state, and federal sectors, rep> resenting expertise in design, operation, and construction cof health facilities. Advisory group members reviewed the 1992-93 edition of the Guidelines line by line, revis- ing details as necessary to accommodate current health care procedures and to provide a desirable environment for patient care at a reasonable facility cost. ‘The Guidelines standards are performance oriented for desired results, Prescriptive measurements, where given, have been carefully considered relative to generally rec- ‘ognized standards and do not require detail specification. For example, experience has shown that it would be extremely difficult to design a patient bedroom smaller than the size suggested and have space for functions and ‘procedures that are normally expected. Authorities adopting the Guidelines standards should encourage design innovations and grant exceptions ‘where the intent of the standards is met. These standards assume that appropriate architectural and engineering practice and compliance with applicable codes will be ‘observed as part of normal professional service and require no separate detailed instructions. In some facility areas or sections, it may be desirable to exceed the Guidelines standards for optimum function. For example, door widths for inpatient hospital rooms are noted as 3 feet 8 inches (1.11 meters), which satisfies ‘most applicable codes, to permit passage of patient beds. However, wider widths of 3 feet 10 inches (1.16 meters) or even 4 feet (1.22 meters) may be desirable to reduce

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