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A Design Guide to the Healthcare Facilities Code 10/16/17 1 A Design Guide to the Health Care Facilities Code NFPA 99 Click to edit Master title style Chad Beebe, FASHE, AIA Deputy Executive Director American Society for Healthcare Engineering
Transcript of 2017 AHCA A Design Guide to the Health Care … 2017_pdfs/A_Facility...A Design Guide to the...
A Design Guide to the Healthcare Facilities Code
10/16/17
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A Design Guide to the Health Care Facilities
CodeNFPA 99
Click to edit Master title style
Chad Beebe, FASHE, AIADeputy Executive Director
American Society for Healthcare Engineering
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Click to edit Master title style
Dave Dagenais, FASHE, CHFM, CHSPDirector of Plant OperationsSafety OfficerWentworth-Douglass Health System
Why NFPA 99 now?
Title 42 - Public HealthCHAPTER IV - CENTERS FOR MEDICARE &MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICESSUBCHAPTER G - STANDARDS AND CERTIFICATIONPART 482 - CONDITIONS OF PARTICIPATION FOR HOSPITALS
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Who regulates hospitals?
Major Regulators
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§482.41 (c) Adoption of NFPA 99, 2012
Directly adopts NFPA 99: Health Care Facilities CodeExcept chapters:
Chapter 7 = IT and Nurse Call
Chapter 8 = Plumbing
Chapter 12 = Emergency Prepare.
Chapter 13 = Security
How NFPA 99 impacts design
Covers more than Med. Gas and ElectricalIncludes Security, Hyperbaric, Fire
Protection, Medical Gas Storage
Important ventilation requirements
Risk based decisions require multi-disciplinary review
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Modifications to other standards
Security Requirements
Security Vulnerability Assessment (SVA) Medication Storage and Work Areas Infant Abduction Security Behavioral Health Clinical Research Security Communications / Data infrastructure Security Physical Access Control
Workplace Violence / Active Shooter
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Medical Gas Requirements
Two Chapters:Med Gas Systems – Chapter 5
The systems, piping, manifolds and valves
Med Gas Equipment – Chapter 11Cylinder Storage Requirements
Fire Protection Requirements
Defend in Place – Defined
Stored Electrical Systems (NFPA 111)
Compact Mobile Storage rooms
Operating Room Fire Protection and Procedures
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Ventilation
Smoke EvacuationCan existing systems be decommissioned?
Humidity
ASHRAE/ASHE/ANSI Standard 170Addenda
Endoscopy – positive or negative?
NFPA 99 – New Format
Beginning with 2012 edition of NFPA 99 the format has been changed to risk based and no longer occupancy based
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Why the Change?
To provide equal level of safety to patients based on the risk to the patient
Create flexibility in the design of healthcare organizations
Equalize the cost of codes in comparison to the safety of the patient (put money where the risk is)
NFPA 99 Risk Layout
Chapters 1-4 Administrative items
Chapters 5-9 Risk of systems
Chapters 10-11 Risk of equipment
Chapter 12 Risk of emergency management needs
Chapter 13 Security needs of all healthcare facilities (SVA)
Chapter 14 Hyperbaric facilities (type of chamber)
Chapter 15 Features of fire protection for all healthcare facilities
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How the Code Works
Determine what the room or space is used for.
Determine the risk to the patient.
Select the appropriate risk category.
Select the systems or procedures in the code that are prescribed by that level of risk category.
Governing Body
The person or persons who have the
overall legal responsibility for the operation of a health care
facility.Many decisions are based on multi-
disciplinary group that may include Architect / Engineer
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Risk
Fundamentals (Chapter 4)
Category 1 - Facility systems in which failure of such equipment or system is likely to cause major injury or death of patients or caregivers shall be designed to meet system Category 1 requirements as defined in this code.
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Fundamentals (Chapter 4)
Category 2 - Facility systems in which failure of such equipment is likely to cause minor injury to patients or caregivers shall be designed to meet system Category 2 requirements as defined in this code.
Fundamentals (Chapter 4)
Category 3 - Facility systems in which failure of such equipment is not likely to cause injury to the patients or caregivers, but can cause patient discomfort shall be designed to meet system Category 3 requirements as defined in this code.
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Fundamentals (Chapter 4)
Category 4 -Facility systems in which failure of such equipment would have no impact on patient care shall be designed to meet system Category 4 requirements as defined in this code.
Fundamentals (Chapter 4)
The risk categories of chapter 4 shall apply to chapter 5-11.
Chapter 12 contains it own categories
Chapters 13 – 15 apply to all without different categories.
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Fundamentals (Chapter 4)
4.2* Risk Assessment. Categories shall be determined by following and documenting a defined risk assessment procedure.
A.4.2 Risk assessment should follow procedures such as those outlined in ISO 31010, NFPA 551, SEMI S10-0307 or other formal process. The results of the assessment procedure should be documented and records retained.
Impact on Design
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Operating Room Suites
OR 1Minor Procedure Room
OR 2 OR 3
OR 4
OR 5OR 6OR Workroom
OR StorageSoiledStorage
1 2
Indicates Space in the room
Emergency Room Suites
DeconRoomTrauma
1Trauma
2Trauma
3Trauma
4ED Holding
Room
Trauma X-Ray
1
2
3
4
5
Indicates Space in the room
Nurse Station
ED 1
ED 2
ED 3ED 4ED 5
IsolationRoom
WaitingRoom
Reception
BH1
BH2
ED 6
GYN
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Nursing Floor
ICU 4
301302
Urgent Care Center
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Same Day Surgery
Medical Office Building
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Imaging Center
Radiation Oncology Center
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Resources
www.ashe.org/resources/riskassessmenttool.shtml
www.ashe.org/resources/wetloctool.shtml
