Middle Priority - Review for Acceptability on these issues and comment on the items that are unacceptable. To review the new or changed text go to www.aia.org/aah_gd_hospcons And click on the appropriate chapter or table
#1 - Chapter 5, Construction - Section 5.1.A
The infection control risk assessment (ICRA) portion has been rewritten and better organized. It also includes a new phrase - infection control mitigation recommendations (ICRMR) which is a program describing the specific methods by which transmission will be avoided during the course of the construction project. The new language clearly identifies the owner as the entity responsible for the ICRA and for monitoring compliance.
#2 - Chapter 7, Hospitals
Section 7.2.B23 - Adding a new requirement for a visitor lounge that is conveniently located and accessible to each nursing unit.
Section 7.4.A3 - In critical care units the size of the patient space did not change but the bed clearance from the transfer side of the bed and foot of the bed to a wall was modified.
Section 7.4.A4b - Added space and provisions for visitors at each bedside.
Section 7.4.E - New language was added in for Newborn Intensive Care Units to bring it current with the other consensus standard published by the American Academy of Pediatrics. Some key issues are:
- Noise control
- Lighting
- Clearance dimensions around the bassinet
Section 7.8 - A new section on In-Hospital Skilled Nursing Units was added.
Section 7.9.B6 - Added a requirement for mandating the sealing of all operating room perimeter walls, ceilings, and floors. This includes making sure all penetrations are sealed.
Section 7.9.D14 - The clear floor space for a PACU single-bed room has been set at 100 sq. ft. with a handwashing station provided in the room.
Section 7.11.E1 - A new section on Observation Units in emergency rooms has been written. Some key issues are:
- Handwashing stations for each four treatment cubicles
- Space at the bedside for visitors
- Provisions for visual privacy
- One toilet room for each eight treatment cubicles
Section 7.13 - A new section on Freestanding Emergency Service has been added to the Guidelines. This is a 24-hour service that is an extension of the hospital emergency service but it is physically separate from the main hospital emergency department.
Section 7.25.B - New central receiving area recommendations are being added that need to be reviewed. Some key items are:
- Dock area shall be separated from occupied building areas so that noise and odors don't adversely affect occupants.
- Convenient to service elevators
- Segregated from waste staging and other outgoing material handling functions
- Space shall be provided to enable breakdown, sorting, and staging of incoming materials
Section 7.33.C1 - New language on waste collection and storage locations.
Table 7.2 - Ventilation Requirements
This table has been modified, here are some of the key items:
- Added a line item for intermediate care
- Changed the current line item of Endoscopy to Gastrointestinal Endoscopy and changed the airflow from In to Out.
- Added a new line item on laser eye room
Section 7.35.K - This is a new section on electronic surveillance systems. Some key items are:
- Defining the types of surveillance systems
- Mounting such that they are unobtrusive and in a tamper-resistant location
- Monitoring devices shall not be readily observable by the general public or patients
- Connected to the emergency power supply system
#3 - Chapter 9, Outpatient Facilities:
Section 9.2.B2 - Establishes a minimum of 80 net square feet for special purpose examination rooms. This net square footage excludes vestibules, toilets, closets, and fixed casework.
Section 9,2,B4 - Treatment room arrangements shall permit a minimum clearance of 3 feet at each side and at the foot of the bed.
Section 9.5.E3 - In outpatient surgical centers the clean and sterile supply room shall have a minimum floor area of 100 net square feet or 50 net square feet per operating room, whichever is greater.
Section 9.5.F2.b - Increases the minimum floor area of a Class A operating room from 120 to 150 square feet with a minimum clear dimension of 12 feet and a minimum clear distance of 3 feet 6 inches at each side, head and foot of the operating table.
Section 9.5.F3.a Establishes a minimum clear floor area of 80 square feet per bed of ambulatory post-anesthetic care units. In addition, a minimum clearance of at least 5 feet between patient stretchers and 4 feet between patient stretchers and adjacent walls shall be provided.
Section 9.5.F4 - Establishes a minimum clear floor area of 50 square feet for each patient lounge chair in a phase II or step-down recovery unit. In addition, a minimal clearance of 4 feet between the sides and foot of the lounge char shall be provided.
Section 9.6 - Changed the name of the section to Freestanding Urgent Care Facility. This section will to facilities that are:
- Not part of a licensed hospital
- Do not provide care on a 24-hour-per-day, seven-days-per-week basis.
- Additionally they must clearly state the type and level of care, the hours of operation, and where the nearest emergency department is that is part of a licensed hospital.
Section 9.6.E1 - For trauma/cardiac rooms in urgent care facilities the minimum clear area of 180 square feet has been increased to 250 square feet excluding vestibule, toilet, closet, and fixed casework.
Section 9.9.A A entire rewrite of the endoscopy facility was performed. The name was changed to Gastrointestinal Endoscopy Facility. Some key features are:
- Facility needs to be divided into three designated areas - unrestricted, semirestricted, and restricted
- Procedure room size of 200 square feet
- Dedicated processing room(s)
- Decontamination room
#3 - Chapter 11, Psychiatric Hospital
A series of changes were introduced to strengthen the documents position on designing safer psychiatric hospitals.
Section 11.1.F1 gives new information on door hardware.
Section 11.1.F2 gives introduces information on clothing storage such as clothing rods or hooks.
Section 11.1.F3 presents new information on private patient bathroom design. Issues such as door swings, ceiling type, plumbing piping, and ductwork are covered in this paragraph.
Section 11.1.F4 gives guidance on bathroom accessories such as grab bars, shower curtains and shower heads.
Section 11.1.F5 gives information on window glazing.
Section 11.1.F6 will require electrical outlets to not allow from unauthorized use or shall be protected with ground fault interrupters.
Section 11.1.F7 presents new material on ceilings mounted devices such as sprinklers, ventilation grills, and light fixtures.
Section 11.2.C - increases the requirement for seclusion treatment rooms from one for up to 24 beds to having one on each psychiatric unit. Other key items in this paragraph are:
- New room length requirements have been added with a minimal dimensional wall length of 7 feet and a maximum wall length of 11 feet.
- The room shall not contain any outside corners or edges.
- The entrance door shall swing out.
#4 - Chapter 13, Hospice Care
An entire chapter has been added. The appendix material from the 2001 edition has been moved up into the body of the text and has been rewritten into requirements for these units.