Home » Health Care Design: Beyond Code Minimum – Creating Healthier, More Efficient Environments
In our June 2021 article, “Heath Care Design: FGI Guidelines, ANSI/ASHRAE/ASHE Standard 170, and Beyond,” we reviewed the codes and standards for health care environments that form the guidelines to be applied at the beginning of a health care facility design. The article highlighted that these minimum requirements are just that — the bare minimum — and indicated the application of these guidelines only started the process for creating safe and comfortable environments conducive to promoting good health care and lowering risks of infection. We challenged current and future mechanical engineers to design past bare minimums and educate clients on the real “value” of designing systems that more appropriately meet the expressed “purpose” of ASHRAE Standard 170. The previous article referenced the quote: “When a flower doesn’t bloom, you fix the environment in which it grows. Not the flower.”1 We, as engineers, need to expand our thinking beyond the status quo and seize the initiative to play a more pivotal role in creating health care facilities that support building environments conducive to good occupant health, personal wellness, and patient healing or recovery.
Facilities are often designed by architectural teams that conform to owner design requests and to a specified budget. Consequently, current mechanical designs are often “shoehorned” into building layouts and predetermined budgets; a design that only maintains desired conditions prescribed as minimal requirements by the Facility Guidelines Institute (FGI) or ASHRAE Standard 170. However, the human cost associated with bare minimum designs are frequently not considered. Hospital-acquired infections (HAI) have long been a part of our world and have been a catalyst to better designs. The pandemic has motivated reassessment of buildings, resulting in engineering designs that more effectively reduce the risk of infection. System resiliency and emergency/pandemic response preparedness have been thrust into the spotlight. However, HAIs haven’t gone away. They remain and draw even more attention to the need for creating healthier built environments. While looking at mechanical systems to address resiliency and pandemic preparedness, we must also enhance designs to eliminate the threat of HAI’s, not ‘first cost’. Unlike the financial considerations, the human cost expands far beyond the monetary factor.
Consequently, mechanical systems should play a more fundamental role in creating healthier environments by providing fresh air, removing airborne contaminants, maintaining proper humidity levels, and promoting asepsis (the absence of bacteria, viruses, and other microorganisms). One could say, HVAC systems are silent partners in securing health care objectives. Patients, visitors, and health care workers are often unaware how important mechanical systems are in keeping them safe. Occupants expect systems to be designed properly, installed correctly, and, quite simply, to work. To allow first cost to be the driving factor does nothing more than support a concept that designing an OK health care environment is just that, OK, and begs the following questions;