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Liaison Report – American Institute of Architects
October 2005

Prepared by: Christopher Upton

In previous reports, I have announced that the new Healthcare Guideline Revisions were being developed and targeted for release in 2006. At the last session of the AIA Committee for Guidelines in Los Angles this past July, it was announced that the publish date for the guidelines for 2006 would be in March of this coming year. The next official issue is scheduled for 2010. Due to many issues that are still unresolved such as the means to deal with Interventional Radiology, It was also announced that there would be interim guidelines considered for publishing in 2008.

Probably one of the most significant and controversial proposed changes would be the making of single-bed private rooms into a minimum standard for new hospital construction. This topic was proposed for the current guidelines issued in 2001, but was voted down as a “shall” issue (making it a shall issue would establish it as a minimum standard). Currently the guidelines have this as a “should” item in the guideline appendix notes. This has caused much discussion in the sessions with the Guideline Committee split about down the middle.

Other aspects of the Guidelines receiving particular attention in the current revision cycle include:
  • a new section on intermediate care units

  • a new section on gastrointestinal endoscopy facilities

  • a new chapter on primary care hospitals (small and rural community facilities)

  • psychiatric outpatient centers

  • assisted living facilities

  • hospice care facilities

  • a new appendix on green architecture (LEED)

The Healthcare Design Guidelines Committee also sponsored a research project for the benefits of single patient rooms vs. semi private. The executive summary and cost guidelines of each are posted on the AAMA website at Executive Summary: single vs Multiple Occupancy Rooms, Nursing Unit Floor Plans Analysis, and One Bed vs. Two Bed Room Cost Comparison.  For more information or to view the draft document, visit www.aia.org/aah.

These guidelines are either the basis for the design code or in some states, the verbatim code that is used by state agencies for review of design documentation by both architectural and engineers. Everyone should make time to download the PDF from the AIA site and submit comments.

One of the stronger continuing arguments for the maintenance of semi private rooms has been the need for surge capacity in hospitals. In geographic areas such as ski and beach resorts the seasonal demand spike for healthcare has been traditionally addressed by utilization of semi private environments. To date there are no definitions on the minimum requirements of such facilities.  In anticipation of a guideline section to be written to address this issue, I have been asked by the guideline committee to chair a committee on the evaluation of defining surge capacity for various types of healthcare facilities. This committee report will initially take to form of an article that I will script in concert with a mechanical engineer, Chris Rosseau of Newcomb and Boyd in Atlanta and a state reviewer from the State of Illinois, Enrique Undale. One of the goals of this committee will be looking at not only surge capacity but addressing an issue of building in a workable means of unit flexibility to not only handle short and long term flexible needs but to also address the creation of Protective Environments vs. Negative Isolation Environments. When completed, a copy of this article will be made available to AAMA members for review and comment.

Should any one in AAMA feel to comment on the guidelines and is unsure or uncomfortable or unsure of how to format comments or suggestions, feel free to get me to assist you. E-mail the comment to me and I will structure it so that it is properly referenced to the specific guideline. My e-mail address is [email protected] Thanks.