Standardizing Healthcare

Healthcare facilities require unique air-quality standards—that philosophy is expected to become "official" as soon as 2004, as ASHRAE SPC (Standards Project Committee) 170P continues work on its Ventilation of Health Care Facilities standard. SPC 170P was put together during the development of ASHRAE's Health Care Design Manual (SP-91), a guide for designing HVAC systems in healthcare...


Healthcare facilities require unique air-quality standards—that philosophy is expected to become "official" as soon as 2004, as ASHRAE SPC (Standards Project Committee) 170P continues work on its Ventilation of Health Care Facilities standard.

SPC 170P was put together during the development of ASHRAE's Health Care Design Manual (SP-91), a guide for designing HVAC systems in healthcare facilities that is expected to be available to the public in June. The upcoming standard is intended as a single reference document for designers that will provide standards for healthcare system design and set new criteria based on new research, and do so via the process of ANSI certification.

"There are a lot of buildings out there right now that haven't been built to any guidelines or have been grandfathered in over the years," says Richard Hermans, P.E., with the Center for Energy and Environment, Minneapolis, and the chairman of SPC 170P. "That is our biggest problem—the inconsistency across the country with the quality of the environment in those healthcare spaces." He cites the huge growth of healthcare facilities in the United States during the 1950s. Many of these buildings still use their original HVAC systems.

To avoid confusion about solutions, there's a need for standardization. "There are a lot of different guidelines out there and a lot of different ways to go about complying with those guidelines. In a few cases, there are some holes in the present guidelines that deal with certain issues, especially ones having to do with ventilation. So, we'd like to patch all of that up."

ASHRAE's SPC 170P was sent for review to the American Society of Health Care Engineering (ASHE), which has agreed in principal to co-sponsor it—a major step, according to Hermans, as ASHE's facilities management experience, combined with the ASHRAE standards-making process, lends significant weight to the effort.

Besides credibility, Hermans says the relationship with ASHE is positive for ASHRAE, given the former organization's connections with other guide-making bodies, such as the Facility Guidelines Institute and the Center for Medicare and Medicaid Services.

The committee, itself, is made up of representation from three different groups—users (facility managers and maintenance personnel); producers (including test and balance contractors and filter manufacturers); and general interest groups, such as consultants.

A issue that the standard considers is the pressure relationship between spaces, as well as which types of spaces should have pressure requirements. It also examines system designs that won't become amplifiers for mold and bacteria growth.

Of course, preventing the spread of airborne pathogens is at the center of the standard. The irony is that in healthcare facilities, where sterilization and germ-free air are paramount, infections and the sources of infectious germs abound.

"I think the biggest thing we're hearing and seeing right now is the infection control issues," adds Pat Banse, P.E., Smith Seckman Reid, Inc., Houston. "You need to control the environment a lot closer in diagnostic testing and patient-care areas than an office building. You do that in offices too, but there is less of an opportunity for problems because people are generally well."

The SPC 170P standard also takes into consideration the fact that healthcare facilities are comprised of many different types of areas, each with specific requirements. For example, an operating room houses a delicate airflow balance that can be thrown into discord by an inappropriate ventilation system. A National Institute of Health study found that skin flakes from a surgeon could find their way into a patient's incision with relative ease. Under ideal circumstances, a patient's body emits a heat plume that repels these particles away. However, an overpowering HVAC system can cancel that heat plume, increasing the chance of infection. Such sensitive issues abound in hospitals, making specific and specialized requirements necessary.

The first public review of SPC 170P is scheduled for June of 2004. How long it takes after that for the standard to be published depends on the nature of the comments the committee receives. When the title, purpose and scope were presented for public scrutiny, the decision was unanimous to move forward. Hermans hopes that reviewers will feel the same way about the standard itself. "We would like to make sure that what we do is non-controversial and that everyone says, 'Yes, that makes sense.' If everyone can do that, then we've got a good standard."

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