WAC 246-320-600   Washington state amendments.  This section contains the Washington state amendments to the 2010 edition of the Guidelines for Design and Construction of Health Care Facilities as published by the American Society for Healthcare Engineering of the American Hospital Association, 155 North Wacker Drive Chicago, IL 60606. Subsections with an asterisk (*) preceding a paragraph number indicates that explanatory or educational material can be found in an appendix item located in the 2010 Guidelines.


CHAPTER 1.1 INTRODUCTION

     1.1-5.5 Referenced Codes and Standards


     Washington State Building Code (http://www.sbcc.wa.gov/)


CHAPTER 1.2 PLANNING, DESIGN, AND IMPLEMENTATION PROCESS

     1.2-6.1.4 Design Criteria for Room Noise Levels

     (1) Room noise levels shall not exceed the sound level ranges shown for the chosen rating system in Table 1.2-2 (Minimum-Maximum Design Criteria for Noise in Interior Spaces).


CHAPTER 2.1 COMMON ELEMENTS FOR HOSPITALS

     2.1-2.6.7 Nourishment Area or Room

     2.1-2.1.6.7.5 Nourishment function may be combined with a clean utility without duplication of sinks and work counters.


     2.1-2.6.12 Environmental Services Room

     2.1-2.6.12.3 Environmental services and soiled rooms may be combined.


     2.1-7.2.3 Surfaces

     2.1-7.2.3.2 Flooring

     2.1-7.2.3.2(14) The floors and wall bases of kitchens, soiled workrooms, and other areas subject to frequent wet cleaning shall be either seamless flooring with integral coved base, sealed ceramic tile with ceramic tile base, or equivalent.


     *2.1-8.2.1 General

     Basic HVAC system requirements are defined in Part 6 of this document, ANSI/ASHRAE/ASHE Standard 170-2008: Ventilation of Health Care Facilities. This section of the Guidelines includes additional requirements.


     *2.1-8.2.1 General

     *2.1-8.2.1.1 Mechanical system design


     (f) VAV systems. The energy-saving potential of variable-air-volume systems is recognized, and the requirements herein are intended to maximize appropriate use of those systems. Any system used for occupied areas shall include provisions to avoid air stagnation in interior spaces where thermostat demands are met by temperatures of surrounding areas and air movement relationship changes if constant volume and variable volume are supplied by one air-handling system with a common pressure dependent return system.


     *2.1-8.2.1.1 Mechanical system design

     (2) Air-handling systems with unitary equipment that serves only one room. These units shall be permitted for use as recirculating units only. All outdoor air shall be provided by a separate air-handling system with proper filtration, as noted in 2.1-8.2.5.1 (Filter efficiencies).

     (a) Recirculating room HVAC units themselves shall have a MERV 6 (or higher) filter in Filter Bank 1 and are not required to have Filter Bank 2. For more information see AIA (2006).

     (b) Recirculating room units shall be allowed in General Laboratory rooms and Sterilizer Equipment rooms provided at least 6 air changes are provided by the air handling system and adequate total cooling capacity is provided.


     2.1-8.2.2 HVAC Requirements for Specific Locations

     2.1-8.2.2.7 Emergency and radiology waiting areas

     When these areas are not enclosed, the exhaust air change rate shall be based on the general volume of the space designated for patients waiting for treatment.


     2.1-8.2.4 HVAC Air Distribution

     2.1-8.2.4.2 HVAC ductwork

     *(2) Humidifiers

     (a) If humidifiers are located upstream of the final filters, they shall be at least twice the rated distance for full moisture absorption upstream of the final filters.

     (b) Ductwork with duct-mounted humidifiers shall have a means of water removal.

     (c) Humidifiers shall be connected to airflow proving switches that prevent humidification unless the required volume of airflow is present or high-limit humidistats are provided.

     (d) All duct takeoffs shall be sufficiently downstream of the humidifier to ensure complete moisture absorption.

     (e) Steam humidifiers shall be used. Reservoir-type water spray or evaporative pan humidifiers shall not be used.

     Appendix Language:

     A2.1-8.2.4.1(2) It is recognized that some facilities may not require humidity control within the ranges in table 2.1-2 and that the final determination of a facility's ability to control humidity will be made by that facility.


     2.1-8.3.7 Call Systems

     2.1-8.3.7.3 Bath Stations

     Appendix Language:

     A2.1-8.3.7.3 Where new construction or renovation work is undertaken, hospitals should make every effort to install assistance systems in all public and staff toilets.


     2.1-8.4.3 Plumbing Fixtures

     2.1-8.4.3.1 General

     (1) Materials. The material used for plumbing fixtures shall be nonabsorptive and acid-resistant.

     (2) Clearances. Water spouts used in lavatories and sinks shall have clearances adequate to:

     (a) avoid contaminating utensils and the contents of carafes, etc.

     (b) provide a minimum clearance of 6" from the bottom of the spout to the flood rim of the sink to support proper hand washing asepsis technique without the user touching the faucet, control levers, or the basin.


     Appendix Language:

     A2.1-8.4.3.2 Aerator usage on water spouts may contribute to the enhanced growth of waterborne organisms and is not recommended.


     2.1-8.4.3.6 Scrub sinks. Freestanding scrub sinks and lavatories used for scrubbing in procedure rooms shall be trimmed with foot, knee, or electronic sensor controls; single-lever wrist blades are not permitted.


CHAPTER 2.2 SPECIFIC REQUIREMENTS FOR GENERAL HOSPITALS


     2.2-2.2 Medical/Surgical Nursing Unit

     2.2-2.2.2 Patient Room

     2.2-2.2.2.1 Capacity

     (1) In new construction, the maximum number of beds per room shall be two.

     (2) Where renovation work is undertaken and the present capacity is more than one patient, maximum room capacity shall be no more than the present capacity with a maximum of four patients.


     *2.2-2.2.2.5 Hand-washing stations

     (1) Location

     (a) A hand-washing station shall be provided in every toilet room serving more than one patient. Alcohol-based hand sanitizers shall be provided where sinks are not required.

     (b) A hand-washing station shall be provided in the patient room in addition to that in the toilet room.

     (i) This hand-washing station shall be convenient for use by health care personnel and others entering and leaving the room.

     (ii) When multi-patient rooms are permitted, this station shall be located outside the patients' cubicle curtains.


     2.2-2.2.6 Support Areas for Medical/Surgical Nursing Units

     2.2-2.2.6.5 Hand-washing stations. For design requirements, see 2.1-2.6.5.

     (1) Hand-washing stations shall be conveniently accessible to the medication station and nourishment area. "Convenient" is defined as not requiring staff to access more than two spaces separated by a door.

     (2) If it is convenient to each area, one hand-washing station shall be permitted to serve several areas.


     2.2-3.2 Freestanding Emergency Care Facility

     2.2-3.2.1 General

     2.2-3.2.1.1 Definition

     (1) "Freestanding emergency care facility" shall mean an extension of an existing hospital emergency department that is physically separate from (i.e., not located on the same campus as) the main hospital emergency department and that is intended to provide comprehensive emergency service.

     (2) A freestanding emergency care facility that does not provide 24-hour-a-day, seven-day-a-week operation or that is not capable of providing basic services as defined for hospital emergency departments shall not be classified as a freestanding emergency care facility and shall be described under other portions of this document. Any facility advertising itself to the public as an emergency department or facility shall meet the requirements of Section 2.2-3.2.


     2.2-3.2.1.2 Application. Except as noted in the following sections, the requirements for freestanding emergency service shall be the same as for hospital emergency service as described in Section 2.2-3.1 (Emergency Service).


     2.2-3.2.2 Facility Requirements

     This section is not adopted


     2.2-3.3.3 Pre- and Postoperative Patient Care Areas

     *2.2-3.3.3.3 Post-anesthetic care unit (PACU)

     (4) Each PACU shall contain the following:

     (a) A medication station.

     (b) Hand-washing stations. At least one hand-washing station with hands-free or wrist-blade operable controls shall be available for every six beds or fraction thereof, uniformly distributed to provide equal access from each bed.

     (c) Nurse station with charting facilities.

     (d) Clinical sink.

     (e) Provisions for bedpan cleaning.

     (f) Storage space for stretchers, supplies, and equipment.

     (g) Staff toilet. A staff toilet shall be located within the working area to maintain staff availability to patients.


     2.2-4.2 Pharmacy Service

     2.2-4.2.1 General: Until final adoption of USP 797 by either federal or other state programs, facilities may request plan review for conformance to USP 797 with their initial submission to the Department of Health, Construction Review Services.


CHAPTER 3.1 OUTPATIENT FACILITIES

     *3.1-3.2.2 General Purpose Examination/Observation Room

     3.1-3.2.2.2 Space requirements

     (3) Existing general purpose examination rooms under review for addition to a hospital license shall be no less than 80 gross square feet and provide a minimum 2'-6" clearance around the examination table.


     3.1-4.1.2 Laboratory Testing/Work Area

     3.1-4.1.2.2 Work counters

     (2) Work counters shall be sufficient to meet equipment specifications and lab technician needs and have the following:

     (a) Sinks.

     (b) Communications service.

     (c) Electrical service.


     3.1-6.1.1 Vehicular Drop-Off and Pedestrian Entrance

     3.1-6.1.1 Vehicular Drop-Off and Pedestrian Entrance (for ambulatory surgery facilities only). This shall be at grade level, sheltered from inclement weather, and accessible to the disabled.


     A3.1-6.1.1 Accessibility requirements for all facility types can be found in 1.1-4.1


     3.1-7.1 Building Codes and Standards


     3.1-7.1.1.2

     This Section is not adopted.


     3.1-7.1.1.3

     This section is not adopted.


     3.1-7.1.3 Provision for Disasters

     3.1-7.1.3.1 Earthquakes

     Seismic force resistance of new construction for outpatient facilities shall comply with Section 1.2-6.5 (Provisions for Disasters). Where the outpatient facility is part of an existing building, that facility shall comply with applicable local codes.


     3.1-7.2.2 Architectural Details

     3.1-7.2.2.1 Corridor width

     (1) Public corridors shall have a minimum width of 5 feet (1.52 meters). Staff-only corridors shall be permitted to be 3 feet 8 inches (1.12 meters) wide unless greater width is required by NFPA 101 (occupant load calculations). Existing clinics that do not use gurneys shall meet the requirements of NFPA 101 for appropriate occupancy type.


     3.1-8.2.4 HVAC Air Distribution

     3.1-8.2.4.1 Return air systems. For patient care areas where invasive applications or procedures are performed and rooms containing materials used in these applications and procedures, return air shall be via ducted systems.


     3.1-8.4.3 Plumbing Fixtures

     3.1-8.4.3.1 General

     (2) Clearances. Water spouts used in lavatories and sinks shall have clearances adequate to:

     (a) avoid contaminating utensils and the contents of carafes, etc.

     (b) provide a minimum clearance of 6" from the bottom of the spout to the flood rim of the sink to support proper hand washing asepsis technique without the user touching the faucet, control levers, or the basin.


     Appendix Language:

     A3.1-8.4.3 Aerator usage on water spouts may contribute to the enhanced growth of waterborne organisms and is not recommended.


CHAPTER 3.2 SPECIFIC REQUIREMENTS FOR PRIMARY CARE OUTPATIENT CENTERS

     3.2-1.3 Site

     3.2-1.3.1 Parking

     This section is not adopted.


CHAPTER 3.3 SPECIFIC REQUIREMENTS FOR SMALL PRIMARY CARE (NEIGHBORHOOD) OUTPATIENT FACILITIES

     3.3-1.3 Site

     3.3-1.3.2 Parking

     This section is not adopted.


CHAPTER 3.7 SPECIFIC REQUIREMENTS FOR OUTPATIENT SURGICAL FACILITIES

     3.7-1.3 Site

     3.7-1.3.2 Parking

     This section is not adopted.


CHAPTER 3.11 SPECIFIC REQUIREMENTS FOR PSYCHIATRIC OUTPATIENT CENTERS

     3.11-1.3 Site

     3.11-1.3.1 Parking

     This section is not adopted.


CHAPTER 5.1 MOBILE, TRANSPORTABLE, AND RELOCATABLE UNITS

     5.1-1.1 Application

     5.1-1.1.1 Unit Types

     This section applies to mobile, transportable, and modular structures as defined below. These units can increase public access to needed services.

     Mobile mammography units do not require review by the Department of Health, Construction Review Services.


     Appendix Language:

     A5.1-1.1.1 The facility providing services, including mobile mammography, should review these requirements in consideration of the service offering and the delivery of care model.


     5.1-7.2 Architectural Details and Surfaces for Unit Construction

     5.1-7.2.2 Surfaces

     If the mobile unit is permanently installed, finishes shall comply with the requirements in this section.


     5.1-7.2.2.1 Interior finish materials

     (1) Interior finish materials shall meet the requirements of NFPA 101.


     5.1-8.6 Safety and Security Systems

     5.1-8.6.1 Fire Alarm System

     Fire alarm notification shall be provided to the facility while the unit is on site.


     5.1-8.6.1.2 Each mobile unit shall provide fire alarm notification by one of the following methods:

     (1) Via an auto-dialer connected to the unit's smoke detectors.

     (2) An audible device located on the outside of the unit.

     (3) Connection to the building fire alarm system.


Part 6

ANSI/ASHRAE/ASHE Standard 170-2008: Ventilation of Health Care Facilities


     Table 7-1 - Design Parameters

Function of Space	RH (k), %
Class B and C operating rooms (m)(n)(o)	max 60
Operating/surgical cystoscopy (m)(n)(o)	max 60
Delivery room (Caesarean) (m)(n)(o)	max 60
Treatment room (p)	max 60
Trauma room (crisis or shock) (c)	max 60
Laser eye room	max 60
Class A Operating/Procedure room (o)(d)	max 60
Endoscopy	max 60

[Statutory Authority: Chapter 70.41 RCW. 10-17-120, § 246-320-600, filed 8/18/10, effective 9/18/10; 08-14-023, § 246-320-600, filed 6/20/08, effective 7/21/08.]