Agency guidance
2010 Guidelines for Design and Construction of Health Care Facilities
The Facility Guidelines Institute (FGI)'s 2010
Guidelines for Design and Construction of Health Care Facilities
provides guidance on minimum program, space, and design guidelines for
clinical and support areas of hospitals, outpatient facilities, and
residential care facilities, along with minimum engineering design criteria
for communications systems. The Joint Commission, many federal agencies,
and authorities in 42 states use the Guidelines either as a code or a
reference standard when reviewing, approving, and financing plans;
surveying, licensing, certifying, or accrediting newly constructed
facilities; or developing their own codes. Health care providers, facility
managers, and design professionals and infection preventionist need a copy
of the updated, 2010 edition to help them stay on top of good practice and
emerging trends in health care design and construction
The guidelines expand on the planning process termed an infection control risk assessment (ICRA), first appearing in the 1996-97 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
For more information about the content of the updated document and an errata sheet, go to: "2010 Edition" www.fgi-guidelines.org For documents associated with the 2010 edition, click the link to "White Papers and Draft Guidelines" to the left. The Guidelines are also available from the American Society for Healthcare Engineering (ASHE) web site
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)
The Joint Commission
The 2003 CDC Guidelines for Environmental Infection Control include recommendations consistent with the current FGI guidelines as well as TJC 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.