Updated FGI Guidelines for 2014

July 29, 2014  |  Maria Ramos & Tina Schweizer, Mechanical Engineers

Healthcare_ASHRAE5The current FGI guidelines will be updated in 2014.  These guidelines are used in conjunction with ASHRAE 170 for specific healthcare-related MEP and other design concerns.  They are not building codes, but rather guidelines used by the Joint Commission; and it is, therefore important that engineers adhere to them in the design of systems for healthcare facilities.  The following changes in the Guidelines and other insights were highlighted in a seminar recently attended by Fosdick & Hilmer healthcare project managers:

    1. The Guidelines were previously referred to as AIA Guidelines until 2006. In 2010, they became the FGI Guidelines (Facility Guidelines Institute).
    2. There are now two books, one for Hospitals and one for Residential Facilities.
    3. Some items do not apply directly to MEP design, but engineers must pay attention so that we can effectively collaborate with the other professionals and the Owner.
    4. Many states do not recognize the FGI Guidelines as an enforceable code, but Joint Commission (JC) surveys according to FGI Guidelines and, therefore, engineering design needs to abide by it. The FGI Guidelines is the standard of care for healthcare design. If it is not met, there has to be a good engineering reason and a reference made to other industry resources like ASHRAE.
    5. The definition of Operating Rooms has changed. There is no longer Class A, B, or C Operating Rooms. Everything will fall into one of two categories: Procedure Room or Operating Room.
    6. The definition of “Invasive Procedure” has been modified. If a space is designed for invasive procedures it will affect how HVAC diffusers are selected and whether low exhausts are required.
    7. No “Open” water features are allowed. The old ones do not have to be taken out, but new ones cannot be installed. “Closed” features are still allowed.
    8. The list of systems requiring Commissioning has expanded.
    9. Patient privacy curtains should not interfere with sinks. This becomes an infection control issue. Engineers should weigh in on sink locations and curtain locations with the architect and users.
    10. Swivettes are no longer permitted in ICU rooms.
    11. The cooling for IT rooms must be on emergency power. This is due to the changing nature of business with so many things being electronic.
    12. Emergency Medical Record (EMR) devices need to be on UPS. This is now considered a “critical” system.
    13. Plumbing sinks have a minimum size requirement of 144 sq. in.
    14. Endoscopy is not considered an invasive procedure. In the air change requirement chart it has a pressure requirement of “N/R” which stands for “No Requirement”. This is not the same as “Neutral”. Where “N/R” is listed, the room can be positive, negative, or neutral. So if the hospital wants this room to double as a bronchoscopy room, which requires negative pressure, the room can be set to negative pressure and be used for both procedures. (Side note: historically people would site odor issues as a reason to keep the Endo room negative or invasive procedure as a reason to keep the room positive. It is not classified as an invasive procedure, and the majority of the odors come from the scope sterilizer. The scope room should be negative pressure.)
    15. Return air plenums are not permitted in patient care areas – inpatient or outpatient. If your spaces require a specific pressure relationship, there cannot be a plenum.
    16. The minimum number of air changes per hour in patient rooms has been reduced to 4, but with restrictions. Since most of the time there is a large window in patient rooms, the minimum for heating and cooling is often well above 4 air changes per hour, so this will not come into play very often.
    17. In a negative isolation room we assume that the transfer air into the room comes from under the door. In reality some of it comes from leakage around the windows. If there is construction going on outdoors, debris could be pulled into the space. Measures should be taken to alleviate this condition.
    18. ICU rooms in the FGI Guidelines have no pressure requirement, but it is recommended that they be positive pressure. This can be slight positive pressure and it does not have to be monitored.

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