It’s that time again—the Guidelines for Design and Construction of Health Care Facilities is currently up for revision with a draft of the 2014 edition ready for publication.
To prepare the healthcare community for the public comment period to come, Douglas S. Erickson, FASHE, CHFM, HFDO, CHC, senior project manager, Northstar Management, described the process of submitting comments on the draft and identified major initiatives in the proposed changes during a plenary session at the ASHE PDC Summit in Phoenix.
The goal of the Guidelines is to provide a series of baseline requirements that have been vetted through an open consensus process, Erickson says. The resulting document will be based on research, science, and expert opinions to set criteria for the design of healthcare facilities that can be enforceable by federal and state agencies.
While there is hope that the Centers for Medicare & Medicaid Services will adopt the guidelines for its approved facilities someday, Erickson made it clear that FGI is not competing against other prevalent code agencies in healthcare, including NFPA, ICC, and ASHRAE.
“We don’t reinvent the wheel,” he says. “[Our] niche is really looking at the patient care environment.”
With 2,525 public proposals submitted for the 2014 Guidelines, a draft has now been developed and will be opened to comments from June 1 through November 25, 2012. After this, the Health Guidelines Revision Committee will vote on the content and make the final guidelines available in January 2014.
As part of the review process in this round of revisions, a cost-benefit analysis has been introduced for the first time. “Cost is something we have to add in,” Erickson says, noting that the assessment takes account of initial cost of a proposed change, the life cycle cost of the change, and the clinical/financial benefit the change may offer.
Among major changes likely coming for 2014 are the addition of guidelines specifically for children’s hospitals and critical access hospitals, as well as the potential for a separate white paper or freestanding guideline outside of the edition that covers furniture specifications and recommendations.
Proposals relating to Part 1 of the Guidelines included patient and caregiver risk assessment, looking at items like infection control, and patient immobility and security. Other common issues considered are sustainability, commissioning, and acoustics.
For Part 2, patient- and family-centered care models were considered for standardization; however, Erickson says the committee decided against it being mandatory for med-surg rooms, though it is a commonly accepted practice in healthcare design today.
Also addressed in Part 2 was uninterruptable power supply for critical information systems so communications would not be lost in cases like the Joplin/Mercy Hospital that was struck by a tornado in May and left entirely without power (go here to read more). At the same time, proposals for a nap room for nurses was shot down as not necessary.
Proposals for Part 3 of the Guidelines touch upon classification of ORs, moving from the A/B/C classifications of old and looking at a new way of doing things. Also considered is the proposed need for 400-square-foot ORs and clarifying the difference between examination and treatment rooms.
For more on the work being done and to take part in the public comment period, please visit www.fgiguidelines.org.