1.

2 PLANNING, DESIGN, CONSTRUCTION, AND COMMISSIONING

'dnhlffl
Infection Control Risk Assessment Design Considerations

Design Element Facility/Patient Care Unit Type Guidelines Section or Other Reference

HVAC Syst ems

HVAC systems Hospital Part 3 (ASH RAE 170)

Water/Plumbing Systems

Potable water supply systems Hospital 2.1-8.4.2.3

Heated potable water distribution Hospital 2.1-8.4.2.5, Table 2.1-3

systems

Hemodialysis/hemoperfusion Hospital 2.1-8.4.2.2, 2.2-3.1 0.8.17

Drainage systems/ condensate/floor Hospital 2.1-4.3.3.3, 2.1-8.4.2.2, 2.1-8.4.2.6, 2.1-8.4.2.7, 2.2-3.1.3.6

drains (8), 2.2-3.10.8

Emergency eyewash and emergency Hospital 2.1-5.1.2.2, 2.1-5.7.2.2, 2.1-8.4.3.8, 2.2-3.4.8.22, 2.2-
shower stations 3.1 0.9.2, 2.2-3.11.4.2

Hand-washing stations (plumbed Hospital 2.1-2.3.4, 2.1 -2.4.2.2, 2.1-2.4.2.3, 2.1 -2.8.7, 2.1 -2.8.11'
sinks) and hand sanitation 2.1-2.8.12, 2.1-3.4.2.5, 2.1-4.1.2.2, 2.1-4.1 .3.2, 2.1 -4.2.8.7,
dispensers 2.1-5.1.2.2, 2.1-5.1.2.3, 2.1-5.2.2.1' 2.1-5.2.2.2, 2.1-5.7.2.2,
2.1-7.2.2.8, 2.1-8.3.5.1, 2.1-8.4.2.5, 2.1-8.4.3.2

Patient care un its 2.1 -2.2.5, 2.2-2.2.2.5, 2.2-2.6.2.5, 2.2-2.9.3.5, 2.2.2-9.11.11'

2.2-2.1 0.8.5, 2.2-2.1 0.8.15

Diagnostic and treatment areas 2.1-3.2.2.2, 2.1-3.2.3.3, 2.1-3.3.2.2, 2.2-3.1.2.7, 2.2-3.1.3.3

(3)(c), 2.2-3.1.3.6 (4), 2.2-3.3.2.5, 2.2-3.4.2.3, 2.2-3.9.8.12,
2.2-3.10.2.5, 2.2-3.10.3.2, 2.2-3.10.8.16, 2.2-3.10.8.17, 2.2-
3.11.4.2

NICU/nursery 2.2-2.8.2.5, 2.2-2.1 0.2.4

Cancer treatment/ infusion therapy 2.2-3.12.2.5

Imaging 2.2-3.4.2.3, 2.2-3.4.3.1, 2.2-3.4.4.2, 2.2-3.4.4.3, 2.2-3.4.4.4,

2.2-3.4.5.2, 2.2-3.4.6.1, 2.2-3.4.7.1' 2.2-3.4.7.2, 2.2-3.4.7.3,
2.2-3.4.7.4, 2.2-3.4.8.19, 2.2-3.5.8.15

Mobile/transportable medical 2.8-3.1.2

units

Hand scrub facilities (scrub sinks) Hospital 2.1-2.8.6, 2.1 -8.3.5.1, 2.1-8.4.3.2, 2.1-8.4.3.6, 2.2-2.9.11.8,
2.2-3.1.3.6, 2.2-3.3.2.5, 2.2-3.3.6.6, 2.2.3-4.2.3

Hydrotherapy faci lities Hospital 2.1-8.4.3.9

Ice making equipment Hospital 2.1-2.8.10, 2.1-8.4.3.4

Sinks- clinical Hospital 2.1-8.4.3.5

Showers/ bathing facilities Hospital 2.1-2.3.6, 2.1 -8.4.3.3

Surfaces and Furnishings

Surfaces Hospital 2.1-7.2.3

Furnishings Hospital 2.1-7.2.4

48 G u idelines for Design a nd Constr u ct i o n of Hosp i tals

 1.2 PLANNING, DESIGN, CONSTRUCTION, AND COMMISSIONING

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Categorization of Hospital Sites by Exterior Ambient Sound with Design
Criteria for Sound Isolation of Exterior Shell in New Construction

Exterior Site Noise Exposure Category

A B c 0

General description Minimal Moderate Significant Extreme

Outdoor day·night average sound level during

< 65 65- 69 70-74 "'75
(Ldnl (dBA)'

Outdoor average hourly nominal maximum

< 75 75- 79 80- 84 "'85
sound level (Lo1l' (dBA)

Design Criteria for Sound Isolation of Exterior Shell in New Construction'

Minimum exterior shell composite sound OITCc: 25 OITCc: 30 OITCc: 35 OITCc: 40

transmission rating'·'·' or or or or
STCc: 35 STCc: 40 STCc:45 STCc: 50

1
By definition, t he day·night average sound level (Ldnl includes t he A-weighting and nighttime penalty.
2
lo1 is the sound level exceeded 1 percent of the time.
3
1n the absence of a local code, emission of equipment sound to adjacent res idential properties shall be considered. Exterior patient seating
areas are generally acceptable for Category A sites, marginally acceptable for Category B sites, generally not acceptable without special
acoustic consideration for Category C sites, and generally not acceptable at all for Category D sites.
( 'The exterior shell composite ratings are for closed windows. Opening windows effectively reduces shell composite OITC or STC ratings to 10
to 15, depending on the amount windows are opened. Consideration shall be given to whether windows would be opened and for how long
[ and under what circumstances, and t he potential impact of open windows should be identified in the design documentation.
5
The exterior shell composite sound transmission ratings for interior spaces that are not acoustically sensitive (e.g., corridors, at riums,
stairways) can be reduced by as much as 10 dB, but should be no less than OITCc 25 or STCc 35. Special consideration shall be given to interior
spaces that are more sensitive to noise than a typical examination room (e.g., a teleconferencing space, telemedicine room, or an auditorium)
[
t hat may req uire special consideration to determine an appropriate OITCc or STCc rating of the exterior facade.
6
For rooms with a roof-ceiling assembly as part of the composite shell, the complete shell (including the roof) shall meet t he requ irements of
t he table in all cases. Where significant sound sources are located above the roof level (such as aircraft or mechanical equipment on roofs)
or the roof is exposed to sound from adj acent noise sources, either the minimum composite OITC or STC of the complete shell (including the
roof) shall be 5 points greater than shown in t he table or the minimum composite OITC or STC of the roof·ceiling assembly itself shall be at
least 10 points greater than shown in t he table wit h the fa~ade composite rating (walls and windows) meeting the minimum requirements in
t he table.
Note: Also see appendix table A1.2-b (Approximate Distance of Noise Sources for Use in Categorization of Hospitals by Exterior Ambient
Sound).

Gu i delines for Design and Construction of Hospitals 49

 1.2 PLANNING, DESIGN, CONSTRUCTION, AND COMMISSIONING

Appendix Table A 1.2-b

Approximate Distance of Noise Sources for Use in Categorization of Hospitals by Exterior Ambient Sound

Exterior Site Noise Exposure Category A 8 c 0

General description Minimal Moderate Significant Extreme

Distance from nearest highway (ft.) > 1000 250-1000 60-249 < 60

Slant distance from nearest aircraft flight track (ft.) > 7000 3500-7000 1800- 3499 < 1800

Distance from nearest rail line (ft.) > 1500 500-1500 100-499 < 100

Notes:

1. This table can be used to approximate noise impact on a hospital based on very conceptual conditions. Actual sound levels at a site can vary
dramatically based on traffic volume and frequency of use of the transportation system as well as topological conditions and other features
out of the control of the design team or health care organization. A more accurate assessment of a site's exterior noise exposure should be
made either by performing a sound level survey for a period sufficient to properly characterize the noise impacts or by using any number of
transportation noise estimation tools, such as software models recognized by the federal government or the noise assessment guidelines in
The Noise Guidebook published by the U.S. Department of Housing and Urban Development.
,2.These criteria should be considered when selecting a location for new construction and expansion projects.

so G u idelines for Design and Constr u ct i on of Hospitals

 1.2 PLANNING, DESIGN, CONSTRUCTION, AND COMMISSIONING

•mn5Fi'
Minimum Design Room-Average Sound Absorption Coefficients (a)

Space' Design Coefficient'

Private patient room 0.15

Multi-bed patient room 0.15

Corridor (patient area) 0.15

Medication safety zone 0.15

Nurse station 0.15

Waiting area (near patient area) 0.25

Atrium 0.10

Office 0.15

Examination room 0.15

Treatment room 0.15

Procedure room 0.15

Class 2 imaging room 0.15

_ 3
Operating room

_ 3
Class 3 imaging room

' Additional spaces shall be added based on the functional program.

2
Use the noise red uction coefficient (NRC) rating for estimating the design room-average sound absorption coefficient when using this table.
3
See appendix section A1.2-6.1.3 (Design criteria for acoustic surfaces).
[Note: If a sound-absorbing panel is attached using mechanical means, that surface is considered permanent.

Gu i delines fo r Design and Construction o f Hospitals 51

 1.2 PLANNING, DESIGN, CONSTRUCTION, AND COMMISSIONING

1¢Mifll
Maximum Design Criteria for Noise in Interior Spaces Caused by Building Systems1

ROOM TYPE NC I RC(N) I RNC'· '· 4 dBA

Patient Care Units

Patient room 40 45

NICU sleep area 30 35

NICU staff and family areas 35 40

Diagnostic and Treatment Locations

Multiple-occupant patient care area 45 50

Examination/treatment room 40 45

Procedure room 40 45

Class 2 imaging room 40 45

Operating room' 50 55

Class 3 imaging room' 50 55

Support Areas

Medication safety zone 40 45

Testing/research lab. minimal speech 55 60

Research lab, extensive speech 50 55

Group teaching lab 4S so

Public Areas

Corridor and public area 4S so

Conference room 3S 40

Teleconferencing room 2S 30

Auditorium 30 35

Large lecture room 30 3S

Administrative Areas

Private office 40 4S

' Additional spaces shall be added based on the building program.

['See the white paper"Sound & Vibration Design Guidelines for Health Care Facilit ies," linked from the FGI website under the Resources tab for
a discussion of room noise rating criteria.
' One rating system shall be chosen to evaluate room noise levels, and noise from building mechanical systems shall be evaluated using that
[ same rating system.
'Spaces shall be designed to fall below the maximum values shown in this table with no rattles or tonal characteristics.
' See appendix section A1.2-6.1.4 (Room noise levels in operating roo ms) for recommended ra nges for operating rooms.

52 G u idelines for Design and Constr u ct i on of Hosp i tals

 1.2 PLANNING, DESIGN, CONSTRUCTION, AND COMMISSIONING

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Design Criteria for Minimum Sound Isolation Performance Between Enclosed Rooms1

Adjacency Combination STCc'

Patient Care Units

Patient room Corridor (with entrance) 35 3

Patient room Patient room (wall-same floor) 454

Patient room Patient room (floor-to-floor) 50

Patient room Consultat ion room 50

Patient room Public space 50

Patient room Service area 60'

Patient room MRI room 60'

Diagnostic and Treatment Locations

Examination room Corridor (with entrance) 35 3

Examination room Examination room (with electronic masking) 406

Examination room Examination room (no electronic masking) 50

Examination room Public space 50

Examination room MRiroom 605

Treatment room Corridor (with entrance) 353

Treatment room Treatment room 50

Operating room Operating room 50

Operating room MRI scanner room 605• 7

Consultation room Public space 50

Consultation room Corridor (with entrance) 353

Public Areas

Toilet room Public space 45

Public space MRI scanner room 50

1
Addit ional spaces shall be added based on the building program.
2The STC values stated assume the need for normal speech privacy as shown in Table 1.2-7 (Design Criteria for Speech Privacy for Enclosed
Rooms and Open-Plan Spaces)-except at corridor walls with doors-assuming a background sound level of at least 30 dBA. When selecting
assemblies based on their tested or published STC ratings, it should be noted that laboratory STC test reports can, in general, be considered
accurate to +I- 2 STC points. Consequently, an assembly with a tested or published STC rating as low as 2 points below the stated minimum
may be considered acceptable.
3
1n cases where greater speech privacy is required between patient care rooms when both room doors to the connecting corridor are closed,
the composite demising wall performance requirement shall be STCc 50.
4
Th is is the performance required for the wall around the door. Note that sound isolation in these instances will be limited by the door's
performance (e.g., STC 20 for a close-fitted 5-PSF door).lt is up to the faci lity to determine if doors require a higher acoustic performance or if
ful l perimeter gasketing and bottom seals should be required. Doors are not required to be sound sealed to maintain the STC rating, although
a facility may choose to do so for specialty patient environments such as bereavement rooms, consultation rooms, sleep therapy roo ms, etc.
sRelaxation of STC 60 ratings shall be permitted if compliance with room noise requirements is achieved with lower performance
constructions. See Table 1.2-5 (Maximum Design Criteria for Noise in Interior Spaces Caused by Building Systems).
6
Electronic masking shall provide a maximum background level of 48 dBA.

Gu i delines for Design and Construction of Hospitals 53

1.2 PLANNING, DESIGN, CONSTRUCTION, AND COMMISSIONING

7This requirement is for operating rooms without doors directly communicating with the MRI scanner room as the STC value shown cannot be
achieved when there is a door between an adjacent OR and an MRI scanner room. However, where there is a connecting door, attention shall
be paid to the door to assure sound isolation when the MRI is used independently from t he operating room.
Note: This table shall not be applied to mobile/transportable medical units.

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Design Criteria for Speech Privacy for Enclosed Rooms and Open-Plan Spaces 1• 2

level Metrics

Speech Privacy-Closed Plan PI AI Sll SPC

Secure N/ A N/A N/A ;?:70

Confidential ;?:95% ~0.05 ~0. 10 60-69

Normal 80-94% 0.06-0.20 0.11- 0.25 52- 59

Defining standard ASTM E1130 ASTM E1130 ANSI S3.5 ASTM E2638

Speech Privacy-Open Plan PI AI Sll SPC

Confidential Special consideration required'

Normal 80- 94% 0.06- 0.20 0.11- 0.25 52-59

Marginal 60- 79% 0.21- 0.40 0.26- 0.45 45-51

Defining standard ASTM E1130 ASTM E1130 ANSI S3.S ASTM E2638

'The ind icated AI and 511 val ues shall be considered the maximum accepted values. The indicated PI and SPC va lues shall be considered the
minimum accepted values.
' Equivalence among these metrics, as indicated, has been demonstrated. However, some of the metrics may not be suitable for a particular
space. The referenced standards indicate that PI and AI are appropriate for use in open-plan spaces and that SPC is appropriate for closed-plan
spaces. The referenced standard for 511indicates it may be used for either type of space.
3
Confidential speech privacy is not readily achievable in open-plan spaces due to the lack of barriers, low ambient sound levels, and typical
voice effort.

54 G u idelines for Design a nd Constr u ct i o n of H osp it als

 1.2 PLANNING, DESIGN, CONSTRUCTION, AND COMMISSIONING

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Maximum Limits on Floor Vibration Caused by Footfalls in Hospitals

Space Type Footfall Vibration Peak Velocity (micro-in/s)

Patient room and other patient areas 6000

Treatment room 6000

Examination room 8000

Class 1 imaging room 8000

Procedure room 4000

Class 2 imaging room 4000

Operating room 4000

Class 3 imaging room 4000

Administrative areas 8000

Public circulation areas 8000

Notes
1. Higher vibration criteria are less stringent and vice versa.
2. The vibration criteria in this table do not apply to renovation projects unless new equipment being installed has more stringent vibration
limits.
3. The vibration criteria in this table do not apply to mobile/transportable medical units.

Gu i delines for Design and Construction of Hospitals 55