FGI Bulletin #18

Comment Period for Draft Emergency Conditions Guidelines Closes June 30

Act now! The Facility Guidelines Institute invites you to review and comment on the draft 2022 Emergency Conditions Guidelines document. The FGI Emergency Conditions Committee (ECC) developed this new standard in response to requests from the public for guidance during the early months of the COVID-19 pandemic. We’re asking you to comment now because you have a stake in its outcome.

If you design, build, own, manage, regulate, or work in health or residential care facilities, you have less than one month left to submit comments on the new FGI Guidelines document on planning for and responding to emergency conditions. Once the public comment period closes, there will be no further opportunities to suggest changes to the new standard.

The draft Emergency Conditions Guidelines organizes new requirements and appendix material by facility type (i.e., hospital, outpatient, and residential care facilities). Because the ECC began writing the standard while the draft 2022 Guidelines documents were still being developed, the proposed text is based on the 2018 edition of the Guidelines. The emphasis now is on collecting and considering comments on the draft.

Because this is a new standard that will supplement the 2022 Guidelines documents, your input on planning, designing, and constructing health and residential care facilities that can withstand and adapt to emergency conditions is imperative.

We encourage users and readers of the Guidelines to carefully review the Emergency Conditions draft and make suggestions where language could be improved by June 30. After that date, the proposed language will be finalized for release with the 2022 Guidelines for Design and Construction documents.

You can download the Emergency Conditions Guidelines draft or find it at the end of the FGI emergency conditions white paper, then submit proposed revisions on the FGI comment platform.

FGI Spotlight: In the Field with Ash Jackson, Colorado AHJ

About FGI Spotlight: Behind every copy of a Guidelines document is the story of an individual and their use of it in the field. In this issue of the Bulletin, we will highlight this intersection through a short Q&A. Would you or someone you know like to be featured? Contact us.

How do you engage with the Guidelines in your field?

As an AHJ, I interact with the Guidelines in a review capacity, applying them to a set of architectural and engineering drawings I’ve received. I work sequentially through the applicable facility-specific sections to try to find where each requirement is being met. If it’s not clear to me that the design of a facility is meeting a particular requirement, I’ll go back to the submitter with questions. It’s important for me to be able to point back to a specific Guidelines section with any question I may have.

How do you do that when cross-references are involved?

Good question. In my reviews, I frequently use tools such as the med/gas outlet table (Table 2.1-3) in the Guidelines for Design and Construction of Hospitals. While this table and others like it are invaluable tools, I must also trace the inclusion of that table in the text of the Guidelines themselves.

For example, I may be looking at the plumbing systems section in Chapter 2.2 (Section 2.2-8.4). Here, the med/gas table is not specifically listed, but there is a cross-reference to the plumbing systems section in the Common Elements chapter (Section 2.1-8.4). When I head over to the Common Elements chapter, I find mention of the med/gas table requirement. So, it helps to be familiar with how the cross-references work and which sections, specifically, I have to point people to when doing reviews.

What part of the Guidelines do you use the most?

One part of the Guidelines I routinely use is the glossary. Whether I’m reminding myself exactly what does and doesn’t constitute a “clear floor area” or explaining to a first-time applicant the Guidelines-specific definition of “room,” the glossary is an invaluable tool for me as an AHJ conducting plan reviews. I also sincerely appreciate how the 2018 edition defines the “location terminology” used in the Guidelines. The glossary, more than any other section of the book, underscores to applicants that I am reading the very same copy of the book that they are and that there are no hidden or secret requirements within the text.

What part of the Guidelines do you use least?

As an AHJ, my use of the Guidelines is limited by the state of Colorado regulations that incorporate them. The department I work with licenses 37 different types of health facilities, of which 22 types require compliance with the Guidelines.

There are whole sections of the Guidelines I am unable to utilize in my professional capacity because we do not license those types of facilities. A Colorado-specific example is the endoscopy center, as the Colorado Department of Health does not have a separate licensing category specific to endoscopy centers. In this instance, we use the ambulatory surgery center chapter.

What tips would you want share with any new AHJs using the Guidelines?

I think it’s important to keep in mind that appendix material is written to be advisory only. In my professional capacity as an AHJ, I cannot use any of the appendix material, only the requirements in the main text.

FGI and IAPMO Announce Memorandum of Understanding

On April 7, 2021, FGI signed a memorandum of understanding (MOU) with the International Association of Plumbing & Mechanical Officials. The organizations have agreed to develop and maintain industry standards that include a focus on water safety in health and residential care facilities. FGI and IAPMO will work together to advance each organization’s documents and, when mutually beneficial, share in educational opportunities, create joint documents, and advocate for each organization.

FGI CEO Doug Erickson shared, “Over the course of my career, I have worked with IAPMO on establishing plumbing and medical gas standards. IAPMO is recognized as a premier organization in promoting water and sanitation safety, and our association will assist in keeping both of our standards consistent and current.” Doug further pointed out, “We are particularly interested in establishing a working group to review and modify the plumbing standards in both organizations’ documents to promote conservation of water and energy in medical and residential care facilities.”

IAPMO is a global leader in providing uniform codes for the plumbing and mechanical industry. FGI and IAPMO have similar approaches to code development, employing a transparent, consensus-based process. In developing its documents, IAPMO leverages the expertise of contractors, engineers, manufacturers, and researchers in the plumbing industry. In addition to code development, IAPMO is North America’s premier mechanical and plumbing product certification agency, providing industry-leading education, personnel certification, product testing and certification, building product evaluation, and a quality assurance program.

More information about IAPMO can be found at www.iapmo.org.

New Errata for the 2018 Guidelines

Download the most current errata sheets for the 2018 Guidelines documents to access the corrections outlined below.

2018 Hospital and Outpatient Guidelines

A Guidelines user noted that the minimum clear width for door openings in a number of Guidelines sections required installation of non-standard-size doors, increasing costs for facility construction. This was not the intention of the Health Guidelines Revision Committee (HGRC), so those dimensions have been adjusted slightly to allow for use of standard-size doors.

2018 Residential Guidelines

Nursing homes. A user inquiry revealed an adjustment was needed to the space requirements per resident bed in a nursing home that were part of the interim amendment incorporated in the second printing of the 2018 Residential Guidelines. The interim amendment language replaced the original 2018 reference to the “area and dimensions provided for each resident space” with clear floor area and clear dimension minimums. In reviewing the diagrams used to determine these minimums, the Residential Document Group determined they had not allowed enough space at the foot of each bed in a multiple-resident room to avoid encroachment by visitors or staff attending to the other resident. Thus, they increased the minimum clear floor area and clear dimension per resident bed in multiple-resident rooms to correct this error. Their review of the diagrams also revealed a two-inch mathematical error in the minimum clear dimension for a single-resident room, which has also been corrected.

Adult day care facilities. The square footage needed per participant in recreation, lounge, and activity areas was difficult to calculate when an adult day care facility would serve participants of differing needs. The Residential Document Group reviewed the language and simplified it for clarity and to meet the intentions of the group.

FGI Recognizes Pamela James Blumgart with the Pioneer Award

About FGI’s Pioneer Award: Sometimes, if we are lucky, an individual or organization in our midst is inspired by the vision of a new path and embodies the pioneering spirit and perseverance to pursue that path. The dedication and passion of these few ignites others to new levels of performance; they are the pioneers and adventurers who lead us to a preferred future. The Pioneer Award of the Facility Guidelines Institute honors select individuals and organizations of outstanding character who influence or create the future of health and residential care facility design and construction through their contributions and support of the mission and vision of the Facility Guidelines Institute.

Woven into the past 23 years of FGI’s Guidelines documents, white papers, bulletins, and website material is the work of one extraordinary editor, colleague, mentor, and friend: Pamela James Blumgart. Pamela appeared on the FGI landscape in 1998, an employee of the American Institute of Architects (AIA) assigned to assist with the 2001 edition of the Guidelines. Having worked on AIA publications such as Architectural Graphic Standards and the Architect’s Handbook of Professional Practice, Pamela became a pivotal figure in Guidelines development, both as an editor and facilitator of the Health Guidelines Revision Committee (HGRC). Doug Erickson, FGI CEO, shares, “It’s always interesting to know how someone becomes a critical player in an enterprise, and with Pamela it is a combination of a great personality, ability to persevere when chaos rules, exceptional people management skills, longevity in the role, and most of all her ability to craft and edit difficult subject matter.”

Following the successful publication of the 2001 edition, Pamela continued putting her indelible mark on the Guidelines. For the 2006 edition, after integrating the work of the HGRC, Pamela and 2006 Vice Chair Martin H. Cohen, FAIA, FACHA, undertook a massive reorganization and renumbering of the document. This job was not for the faint of heart, but the herculean task met its match in Pamela. Doug Erickson explains, “It takes a special person to not only navigate through the codes and standards world, but to manage the thoughts and directives of numerous high-level professionals involved in developing them. Since her beginning with FGI, Pamela has shown a resounding ability to capture thoughts, create text language, and communicate the rationale behind her actions to the committee and the public.”

For the 2010 edition, Pamela worked with Skip Gregory, NCARB, to standardize the numbering of support areas and the location terminology used in the Guidelines. During the next revision cycle, as senior editor at the American Society for Health Care Engineering, Pamela helped finalize what would become the first edition of the FGI Guidelines for Design and Construction of Residential Health, Care, and Support Facilities, at the same time completing the 2014 FGI Guidelines for Design and Construction of Hospitals and Outpatient Facilities. Pamela’s organizational and editorial skills were paramount in the following revision cycle when the Guidelines were further subdivided into three documents for the 2018 edition.

During the 2022 cycle, in addition to supporting the work of the Outpatient Document Group, Pamela assisted FGI with the development of two white papers: “Patient Handling and Mobility Assessments (PHAMA), 2nd ed.” and “Guidance for Designing Health and Residential Care Facilities that Respond and Adapt to Emergency Conditions,” the latter developed and published against the backdrop of an international pandemic. While both were monumental efforts made possible by the work of many, there is no doubt Pamela’s keen eye and organization served as the backbone to the successful end products.

Due to her familiarity and longevity with the Guidelines, Pamela offers a unique perspective as a historian of the process. For example, she recalls “mailing out big stacks of paper” with all the proposals and later all the comments to each HGRC member in the years before electronic media were fully deployed to assist with the process. What’s more, in the early days, Pamela didn’t have an editorial team working alongside her and was mostly going it alone, with one freelance editor and interested volunteers to support the HGRC during meetings. It seems fitting that Pamela’s start with FGI coincides with the year Google was founded; those who have the privilege of working with her would agree she has become akin to our own walking-talking Guidelines search engine, able to provide organizational information, section numbers, and historical background at the drop of a hat.

FGI Managing Editor Heather Livingston shares, “For more than 20 years, Pamela has steadily worked to improve the organization and clarity of the Guidelines documents. Her career is defined by editorial excellence and dedication to craft, blended with the warmth, kindness, and sincerity that are hallmarks of her personality. Wherever Pamela is known, she’s highly esteemed. Pamela Blumgart has been—and continues to be—the heart and soul of the Guidelines.” It is the privilege of the FGI Board of Directors to bestow the FGI Pioneer Award on Pamela James Blumgart. Congratulations, Pamela!

FGI Congratulates Heather B. Livingston on Promotion to COO

FGI announces the promotion of Heather Livingston to the position of chief operating officer (COO). Over the past four years, Heather has worked tirelessly to strengthen our staff, improve our brand, and expand on the offerings of FGI. As the director of operations and managing editor, she and her staff have succeeded in keeping the processing of the 2022 series of Guidelines on track for release in January 2022; this was no simple task given the challenges encountered during the COVID-19 pandemic. At the same time, Heather was responsible for managing the yearlong monumental undertaking that led to publication of the 716-page white paper Guidance for Designing Health and Residential Facilities that Respond and Adapt to Emergency Conditions.

While she has worked on many executive functions over the past four years, this promotion formally promotes Heather to the executive ranks of FGI, where she will take on additional responsibilities for growing and promoting FGI’s brand, enhancing the quality of our offerings, building financial stability, and developing new opportunities to support the organization’s mission and vision. In addition to her new role as COO, Heather will continue as managing editor of the FGI Guidelines. Please join us in congratulating Heather for her promotion to chief operating officer of FGI.