Part 1 General

Part 2 Hospital Facility Types

ANSI/ASHRAE/ASHE Standard 170-2017 Ventilation of Health Care Facilities

Heads up: There are no amended sections in this chapter.
Appendix material, shown in shaded boxes at the bottom of the page, is advisory only.
This chapter contains specific requirements for facilities that provide general acute pediatric hospital care-hereafter referred to as "children's hospitals"-and identify and market themselves to the general public as children's hospitals, pediatric health care centers, or pediatric centers of excellence.
The children's hospital shall meet the standards described in this chapter and the standards in Part 1 of these Guidelines.
The requirements described in Chapter 2.1, Common Elements for Hospitals, and Chapter 2.2, Specific Requirements for General Hospitals, shall apply to children's hospitals when referenced in this chapter.
This chapter shall not apply to independent specialty hospitals with clinical specialization in areas such as burn, psychiatric, orthopedics, rehabilitation, or specific chronic diseases.
See Section 1.3-3.4 (Parking) for requirements.
A2.7-1.3.2 Parking. Children and families often arrive at children's hospitals with siblings and a range of equipment, including strollers, baby carriers, and toys. Parking should include a drop-off area for patients and families at the entrance to the hospital. The size of the area and other requirements necessary to support the unloading of vehicles should be described in the functional program. The drop-off area should be designed to accommodate the time needed to unload, and special care should be given to provide safe spaces for children to wait as their caregivers unload the vehicles.
Patient care units in children's hospitals shall meet the minimum design requirements described in Section 2.7-2.2 (Pediatric Medical/Surgical Patient Care Unit) as applicable.
When compliance with this section is impractical for renovation of patient care units in an existing children's hospital, see Section 1.1-3 (Renovation) for further guidance.
Where accommodations for care of patients of size are provided, they shall meet the requirements in Section 2.1-2.3 (Accommodations for Care of Patients of Size).
A2.7-2.2 Pediatric medical/surgical patient care unit. Early in the planning of medical/surgical units for children's hospitals, the organization of the units should be decided based on patient characteristics such as age, diagnosis, gender, or combinations of these and other relevant attributes.
See Section 2.2-2.2.2.1 (Medical/Surgical Patient Care Unit: Patient Room-Capacity) for requirements.
(1) Area
(a) Patient rooms shall have a minimum clear floor area of 120 square feet (11.15 square meters) per bed in single-patient and in multi-patient rooms.
(b) A family zone that includes the following items shall be provided at each bedside without limiting or encroaching on the minimum clearance requirements for staff and medical equipment around the patient's bed.
(i) Space to sit
(ii) Facilities for family and visitor hygiene
(iii) Storage for family and visitor personal belongings
*(c) Space shall be provided for recumbent sleep of a parent/visitor. Where the parent sleeping area is separate from the patient room, it shall be directly accessible to and have a communication link with the patient unit.
(2) Clearances. The dimensions and arrangement of rooms shall provide a minimum clearance of 4 feet (122 centimeters) between the sides and foot of the bed and any wall or any other fixed obstruction, whether in single-patient or multiple-patient rooms.
A2.7-2.2.2.2 In new construction, single-patient rooms should be at least 12 feet (3.66 meters) wide by 13 feet (3.96 meters) deep (or approximately 160 square feet, or 14.86 square meters) exclusive of toilet rooms, closets, lockers, wardrobes, alcoves, or vestibules. These spaces should accommodate comfortable furniture for family members (one or two) without blocking access of staff members to patients. Movable seating to support visitation and teaming around the patient should be available in quantities sufficient to meet the needs described in the functional program. Efforts should be made to provide the patient with some control of the room environment.
A2.7-2.2.2.2 (1)(c) Parent sleeping area. Preferably, space for recumbent sleep of a parent should be located in the patient room.
See Section 2.1-7.2.2.5 (Windows in patient rooms) for requirements.
See Section 2.1-2.1.2 (Patient Privacy) for requirements.
See Section 2.1-2.2.5 (Hand-Washing Station in the Patient Room) for requirements.
See Section 2.1-2.2.6 (Patient Toilet Room) for requirements.
See Section 2.2-2.2.2.7 (Patient bathing facilities) for requirements.
A2.7-2.2.2.7 Patient bathing facilities. Since children's hospitals provide care for patients from the youngest premature babies to young adults, bathing facility design should accommodate the full range of bathing requirements. Infants may be best served by sink-height bathing bowls, young children by tubs, and adolescents and young adults by flexible showers. Bathing needs should be addressed for each patient care unit, with thought given to flexibility for ongoing change in space use.
See Section 2.1-2.2.8 (Patient Storage) for requirements.
Where a palliative care room is provided, it shall be a single-patient room.
A2.7-2.2.4.1 Palliative care room. Each children's hospital should evaluate the needs and requirements for palliative care programs and plan appropriate corresponding spaces. Children's hospitals typically treat more acutely ill patients, who often have more complex and sensitive health care needs than patients in most general hospitals. When children's hospitals need this broader spectrum of supportive and palliative care services, the following requirements should be met:
  1. Area and dimensions. A palliative care room should have a minimum clear floor area of 250 square feet (23.22 square meters) with a minimum clear dimension of 15 feet (4.57 meters).
  2. Family area. Additional area should be provided to accommodate the extended family and friends. At minimum, this should be an additional clear floor area of 30 square feet (2.79 square meters) per family member permitted by the facility at one time. This additional area may be provided in an adjacent, preferably connected room. This area or suite can be configured so that when not required for palliative care functions, the additional space is readily available to the general unit for consultation space.
  3. Environment of care. Consideration should be given to locating palliative care rooms in a low-traffic location (e.g., the end of a patient care unit) and providing a homelike atmosphere and furniture arrangements as well as orienting the patient bed toward windows with outside views.
  4. Bereavement. On-unit grieving rooms or meditation and respite spaces should be provided.
  5. Storage space. Space to store palliative care carts and related materials and supplies should be provided.
  6. Access should be provided to off-unit consultation and administrative space when this is not provided on the unit.
  1. At least one AII room shall be provided for each pediatric unit.
  2. See sections 2.1-2.4.2 (AII Room) and 2.2-2.2.4.2 (AII room) for requirements.
Where a PE room(s) is provided, it shall meet the requirements of Section 2.2-2.2.4.4 (PE room).
Where a combination AII/PE room(s) is provided, it shall meet the requirements of Section 2.2-2.2.4.5 (Combination AII/PE room).
Where a bone marrow/stem cell transplant unit is provided, it shall meet the requirements of Section 2.2-2.3.4 (Special Oncology Patient Care Unit-Bone Marrow/Stem Cell Transplant Unit).
Where a medical psychiatric room(s) is provided, it shall meet the requirements of Section 2.2-2.2.4.6 (Medical psychiatric room).
The support areas noted shall be provided in or readily accessible to each patient care unit and meet the requirements in Section 2.1-2.8 (Support Areas for Patient Care Units and Other Patient Care Areas) as amended in this section.
  1. Clean linen storage
  2. Equipment storage room or alcove. This shall include space to permit exchange of beds from cribs to adult sizes and storage of furnishings to accommodate parents when furniture is not built-in.
  3. Storage space for stretchers and wheelchairs
  4. Emergency equipment storage
  5. Storage for toys and for educational and recreational equipment and supplies
  1. A single-patient examination room shall be provided in accordance with the requirements in Section 2.1-3.2.2 (Single-Patient Examination Room).
  2. A centrally located examination room(s) shall be permitted to serve more than one patient care unit on the same floor.
Patient play or activity areas shall be provided in multipurpose or individual room(s) in or adjacent to areas serving pediatric and adolescent inpatients.
  1. Play areas shall be sized based on the patient population requirements.
  2. Play areas shall be designed to support play, recreation, and other functions such as dining and education.
  3. Play areas shall provide access and equipment for patients with physical restrictions.
  4. Play areas shall be void of sharp edges and constructed of surfaces and materials that are cleanable, able to withstand the cleaning solutions used, and durable.
A2.7-2.2.8.16 Patient play area. Play is essential to children's healthy development. Dedicated play and activity areas serving pediatric and adolescent inpatients should provide continuous ongoing access. These space(s) may support multiple functions, including child activities of daily living and education programs, but need to be accessible to patients when not programmed for specific activities. In addition, dedicated activity space may be required for teens. The functional program should include information on the play/activity areas needed for the patient population.
See 2.2-2.8.8.17 (Infant feeding preparation facilities) for requirements.
See Section 2.1-2.9 (Support Areas for Staff) for requirements.
Each patient care unit shall have access to a lounge for family and visitors that meets the requirements in Section 2.1-2.10.1 (Family and Visitor Lounge) as amended in this section.
  1. The size of this lounge shall be based on the number of beds served.
  2. A private area for communication (e.g., cell phones, computers, wireless Internet access, patient-family information stations) shall be provided for family and visitors.
A toilet room(s) with hand-washing station shall be located readily accessible to the lounge.
  1. Patient use. Where the toilet room(s) will be used by patients, it shall be designed and equipped for patient use in accordance with Section 2.1-2.2.6.3 (Patient Toilet Room-Room features).
  2. Public use. Designation of the toilet room(s) serving the family and visitor lounge for use by the public shall be permitted.
  3. Diaper-changing station(s)
    1. Toilet rooms serving lounges shall include space for a built-in diaper-changing station that can function without obstructing use of the toilet, sink, door, or other fixtures.
    2. At least one public toilet shall have a diaper-changing station.
An individual room in accordance with Section 2.1-2.8.5 (Multipurpose Room) shall be provided.
This unit shall meet the requirements in Section 2.2-2.3 (Oncology Patient Care Unit) as amended in this section.
See Section 2.7-2.2.10 (Support Areas for Patients, Families, and Visitors) for requirements in addition to those in this section.
A2.7-2.3.10 Due to the bone marrow transplant patient's long lengths of stay in an isolated room or unit, additional space should be provided in the isolated space for child life activities, education, and family needs.
Patient play or activity areas shall be provided in multipurpose or individual room(s) located in or next to areas serving pediatric and adolescent oncology patients in accordance with Section 2.7-2.2.8.16 (Patient play area).
Development of the functional program shall include staffing levels, isolation, transportation, life support, and environmental systems for children requiring critical care.
The size, number, and type of critical care facilities in a children's hospital shall be as specified in the functional program.
See Section 2.2-2.6.1 (Critical Care Unit-General) for general critical care unit requirements.
The requirements in this section shall apply to all types of critical care units in the children's hospital unless otherwise noted.
  1. Space provided shall meet the requirements in these sections:
    1. Section 2.2-2.6.2.2 (Critical Care Patient Care Areas-Space requirements)
    2. Section 2.2-2.7.2.2 (Pediatric Critical Care Patient Rooms and Areas-Space requirements)
  2. Critical care patient rooms designed for specialized procedures requiring additional space, such as extracorporeal membrane oxygenation (ECMO), shall have a minimum clear floor area of 300 square feet (27.87 square meters).
See sections 2.1-7.2.2.5 (Windows in patient rooms) and 2.2-2.6.2.3 (Windows) for requirements.
See Section 2.2-2.6.2.4 (Patient privacy) for requirements
See 2.2-2.6.2.5 (Hand-washing stations) for requirements.
See Section 2.2-2.6.2.6 (Toilet room or human waste disposal room) for requirements.
See Section 2.1-8.5.1 (Call Systems) for requirements.
See Section 2.2-2.6.4.2 (Airborne infection isolation room) for requirements.
Support areas shall be provided in accordance with Section 2.2-2.6.8 (Support Areas for the Critical Care Unit) as modified in this section.
Provisions for storage of formula and human milk shall be provided in accordance with Section 2.2-2.8.8.17 (Infant feeding preparation facilities).
Where provided, examination rooms shall meet the requirements in Section 2.7-2.2.8.15 (Examination room).
See Section 2.2-2.6.9 (Support Areas for Staff) for requirements.
The following support areas shall be provided. Location of these areas outside the critical care unit shall be permitted if they are readily accessible to the unit.
  1. A lounge shall be provided that meets the requirements in Section 2.7-2.2.10.1 (Family and visitor lounge) as amended in this section.
  2. The lounge shall provide a seating capacity of no fewer than 1.5 seats per patient bed.
This room shall be provided in or readily accessible to the pediatric critical care unit for private discussions.
A2.7-2.7 Critically ill cardiac pediatric patients have unique physical and psychological needs with wide variation in ages and sizes.
Where a cardiac critical care unit is provided, it shall meet the requirements in Section 2.7-2.6 (Pediatric Critical Care Unit).
Where a NICU is provided, it shall meet the requirements in Section 2.2-2.8 (NICU).
Where an obstetrical unit is provided, it shall meet the requirements in Section 2.2-2.9 (Obstetrical Unit).
When an obstetrical unit is included in the children's hospital, newborn nurseries shall be provided in accordance with Section 2.2-2.10 (Nursery Unit).
Where a pediatric psychiatric patient care unit is included in the children's hospital, the requirements in this section shall be met.
See Section 2.5-2.2.2 (General Psychiatric Patient Care Unit-Patient Bedroom) for requirements.
See Section 2.1-2.4.3 (Seclusion Room) for requirements.
See sections 2.5-7.2 (Architectural Details, Surfaces, and Furnishings) and 2.5-8 (Building Systems) for requirements.
See Section 2.5-2.2.8 (Support Areas for the Psychiatric Patient Care Unit) for requirements.
See Section 2.5-2.2.9 (Support Areas for Staff) for requirements.
See Section 2.5-2.2.10 (Support Areas for Patients and Visitors) for requirements.
Where a bariatric patient care unit is provided in the children's hospital, it shall meet the requirements of Section 2.7-2.2 (Pediatric Medical/Surgical Patient Care Unit) and the requirements in Section 2.1-2.3 (Accommodations for Care of Patients of Size).
Facilities for basic emergency services shall be provided in accordance with Section 2.2-3.1.2 (Basic Emergency Care) as amended in this section.
Children's hospitals that offer more than basic emergency services shall have facilities for the services they provide that meet the requirements in Section 2.2-3.1.3 (Emergency Department) as amended by the children's hospital-specific emergency department requirements in this section.
Treatment rooms shall meet the requirements in Section 2.2-3.1.3.6 (5)(a) (Pediatric treatment rooms).
Support areas for the emergency department shall be provided in accordance with Section 2.2-3.1.8 (Support Areas for the Emergency Department as amended in this section.
Patient play or activity areas shall be provided in multipurpose or individual room(s) that are in or next to areas serving emergency services pediatric and adolescent patients in accordance with Section 2.7-2.2.8.16 (Patient play area).
Where an observation unit is included in the children's hospital, it shall be provided in accordance with Section 2.2-3.2 (Observation Unit) as amended in this section.
Each patient bed area shall have space at bedside for families and visitors.
Facilities for surgical services shall be provided in accordance with Section 2.2-3.3 (Surgical Services) as amended in this section.
Where a sedation room is provided, it shall meet the requirements in this section.
Combination of the sedation room with other spaces that are separate from the operating or procedure room (e.g., preoperative or recovery spaces) shall be permitted.
The number of sedation rooms provided shall be determined during the planning phase.
The size of sedation rooms shall be determined during the planning phase.
Facilities for imaging services shall be provided in accordance with Section 2.2-3.4 (Imaging Services) as amended in this section.
Mammography rooms shall not be required in children's hospitals.
Suites for MRI equipment shall be planned to conform to the four-zone screening and access control protocols identified in the American College of Radiology's "ACR Guidance Document for Safe MR Practices," including the section on "Pediatric MR Safety Concerns."
Where a sedation room is provided, it shall meet the requirements in Section 2.7-3.3.4 (Sedation room).
Where radiation therapy services are provided, the facilities shall meet the requirements in Section 2.2-3.5 (Radiation Therapy).
Facilities for rehabilitation therapy services shall be provided in accordance with Section 2.6-3.1 (Rehabilitation Therapy).
Where respiratory therapy services are provided, they shall meet the requirements in Section 2.2-3.9 (Respiratory Therapy).
Where outpatient respiratory services (e.g., testing, demonstration, and education for patients) are provided, room(s) where children can practice activities of daily living and related storage shall be provided in addition to the other requirements in Section 2.6.3.1.3 (Occupational Therapy Areas).
Where renal dialysis therapy services (acute and chronic) are provided, they shall meet the requirements in Section 2.2-3.10 (Renal Dialysis Services).
  1. A blood collection room that meets the requirements in Section 2.1-4.1.3.2 (Specimen Collection Facilities-Facility requirements) shall be provided.
  2. A toilet room shall be provided adjacent to the blood collection room.
Where gastrointestinal endoscopy services are provided, the facilities shall meet the requirements in_ Section 2.2-3.11 (Endoscopy Services).
Where chemotherapy/infusion therapy services are provided, facilities shall meet the requirements in Section 2.2-3.12 (Cancer Treatment/Infusion Therapy).
Where a hyperbaric suite is provided, it shall meet the requirements in Section 2.2-3.13 (Hyperbaric Suite).
Laboratory services shall meet the requirements of Section 2.1-4.1 (Laboratory Services) as amended in this section.
Blood draw areas shall be located adjacent to a patient toilet room.
An enclosed room shall be provided for blood draws.
See Section 2.1-4.2 (Pharmacy Services) for requirements.
See Section 2.1-4.3 (Food and Nutrition Services) for requirements.
See Section 2.1-5.1 (Sterile Processing) for requirements.
Facilities for linen services in children's hospitals shall comply with requirements in Section 2.1-5.2 (Linen Services) and the further requirements in this section.
Space shall be provided to accommodate a washing machine/dryer and dishwasher for the purpose of laundering and/or washing plush toys and hard plastic toys.
A2.7-5.2.2 Special laundry facilities. Space should be provided to accommodate a washing machine/dryer accessible to families for the purpose of laundering their personal clothing when they are staying with their children during extended hospitalizations.
See Section 2.1-5.3 (Materials Management) for requirements and additional requirements in this section.
See Section 2.1-5.4 (Waste Management) for requirements.
See Section 2.1-5.5 (Environmental Services) for requirements.
See Section 2.1-5.6 (Engineering and Maintenance Services) for requirements.
See Section 2.1-6.1 (Public and Administrative Areas-General) for requirements.
Public areas in children's hospitals shall meet the requirements in Section 2.1-6.2 (Public Areas) as amended in this section.
At least one toilet room in main public areas serving lounges, dining areas, and lobbies shall include space for a built-in diaper-changing station that can function without obstructing use of the toilet, the sink, the door, or other fixtures.
See Section 2.1-6.3 (Administrative Areas) for requirements.
See Section 2.1-7 (Design and Construction Requirements) for requirements.
See Section 2.1-8 (Building Systems) for requirements.
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