Agency guidance
AIA 2006 Guidelines for Design and Construction of Hospitals and Health Care Facilities
The AIA guidelines are published by the American Institute of Architects/Academy of Architecture for Health/Facility Guidelines Institute (AIA/FGI) with assistance from the Department of Health and Human Services (DHHS). The guidelines expand on the planning process termed an infection control risk assessment (ICRA), first appearing in the 1996-97 AIA Guidelines. As a consensus guideline, it relies heavily on input from groups including the American Society of Healthcare Engineering (ASHE) and the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE), and is deliberately consistent with all published guidelines from the Centers for Disease Control and Prevention (CDC). The FGI offers a formal interpretation process to address substantive questions about the content of the Guidelines
The Guidelines for Design and Construction of Hospital and Health Care
Facilities may be ordered from the Web site below or purchased from the AIA
Bookstore (1735 New York Ave., NW, Washington DC 20006) by
calling 1-800-242-3837 (option 4) or by sending an e-mail message to
bookstore@aia.org
2006 AIA Guidelines and AIA Guideline interpretations:
http://www.aia.org/aah_gd_hospcons
The guidelines are also available from: http://www.fgiguidelines.org/about.html.
Public proposal period open for AIA 2010 Guidelines for Design and Construction of Health Care Facilities
The Health Guidelines Revision Committee (HGRC), with the support of the Facility Guidelines Institute (FGI) and the American Institute of Architects (AIA), seeks proposals from the public for the development of the Guidelines for Design and Construction of Health Care Facilities 2010 edition. The time period for the public to submit changes opened in May, 2007 and will end September 30, 2007. After September this the public will be able to comment on proposed changes only.
Guidelines proposal period release 5.17 (.pdf) (57 KB)
Or go to www.fgi-guidelines.org See "Changes to Guidelines."
CDC Centers for Disease Control and Prevention
guidelines
CDC provides a number of guidelines important to HCF design. The following are the most pertinent to construction, renovation and the ICRA.
CDC - Guideline for Environmental Infection Control in Health-Care
Facilities, 2003
Recommendations of CDC and the Healthcare Infection Control Practices
Advisory Committee (HICPAC).
Guidelines include executive summary and ranked recommendations for reducing infection risk related to air and water environmental concerns, the ICRA, cleaning and disinfecting environmental surfaces, environmental culturing, laundry and bedding, managing regulated medical waste, construction and renovation, use of carpeting, pest control, animals in healthcare facilities, water quality in hemodialysis, and water sampling for Legionella.
The complete 200-page guideline, including all the background information and full appendices will be posted when available in the near future.
Environmental IC 2003 (.pdf) (1 MB)
Guidelines for Preventing Healthcare-associated Pneumonia, 2003.
MMWR 2004;53(RR-3):1-36
Includes literature review, surveillance and control measures for bacterial pneumonia, Aspergillus, Legionella, Influenza and other causes of pneumonia, including detailed appendices.
Pneumonia 2003 (.pdf) (162 KB)
Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities, 2005. MMWR 2005; 54 (No. RR-17, 1-141).
These 1994 CDC/National Institute for Occupational Safety and Health (NIOSH) Guidelines are undergoing revision for 2004.
Tuberculosis 2005 (.pdf) (1.8 MB)
JCAHO Joint Commission on Accreditation of Healthcare Organizations
The 2003 CDC Guidelines for Environmental Infection Control include recommendations consistent with the current AIA guidelines as well as JCAHO standards for the Environment of Care. The following excerpts from EOC standards excerpts are pertinent to the ICRA
Standard EC.7.10
Process for installing and maintaining appropriate:
- Pressure relationships, air exchange rates, air filtration efficiencies to control biological agents, gases, fumes, dust.
- Special areas (OR, special procedure rooms, delivery, sterile supply, laboratories, airborne infection isolation (AII) rooms and protective environments (PE).
- Use: Local exhaust; dilution (Air changes per hour); pressure differential; air cleaning; control relative humidity.
Standard EC.8.3.0 Standard implemented 1/1/02:
- When planning demolition, construction or renovation work, the organization conducts a proactive risk assessment.
- The scope and nature of the activities should determine the extent of risk assessment required.
- The risk criteria address the effect activities have on air quality, infection control, utilities, noise, vibration, emergency procedures.
- As required, the organization selects and implements proper controls to reduce risk and minimize impact.