Part 1 General

Part 2 Outpatient 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 shall apply to outpatient psychiatric centers that provide community outpatient psychiatric services.
The outpatient psychiatric center shall meet the standards described in this chapter and the standards in Part 1 of these Guidelines.
Requirements in Chapter 2.1, Common Elements for Outpatient Facilities, shall apply to outpatient psychiatric centers as cross-referenced in this chapter.
The requirements in this chapter are not to be interpreted to inhibit placement of small neighborhood outpatient psychiatric centers (i.e., units with four or fewer employees) into existing commercial and residential facilities.
Facilities shall be provided for the services provided in the outpatient psychiatric center.
Where the need is indicated by the safety risk assessment (see Section 1.2-4.6, Behavioral and Mental Health Risk Assessment) or requirements in this chapter, the following shall be provided in behavioral health provider/counselor offices, consultation rooms, group rooms, and other locations where staff and patients interact:
Space for a clear path of escape for staff
A2.11-3.2.1.1 Staff safety consideration in areas for patient services. This may be achieved by providing sufficient space to allow placement of the furniture whereby the staff member is always between the patient and the escape path or by providing two exit doors.
A staff assist device to communicate with other staff, internal or external, when assistance is needed
Where an examination room(s) is provided, it shall meet the requirements in Section 2.1-3.2.1 (Examination Rooms).
Where distance psychiatric services are provided in the outpatient psychiatric center, see Section 2.1-3.4 (Accommodations for Telemedicine Services) for requirements.
A2.11-3.2.4 Consultation rooms. These rooms are used for one-on-one counseling or therapy.
A minimum clear floor area of 100 square feet (9.29 square meters) shall be provided.
A2.11-3.2.4.1 Consultation room size. The size of this room is intended to allow for various configurations of furniture and equipment to accommodate the therapeutic modality provided.
Each consultation room shall include a staff assist device to allow staff to communicate with other staff members, internal or external, when assistance is needed.
A2.11-3.2.5 Group rooms. Group rooms are intended to provide a therapeutic group environment in which clients and staff can communicate and interact with each other and address client needs in a communal atmosphere. Group rooms may vary in size depending on the services offered and number of clients served at one time.
  1. Size and dimensions of group rooms shall accommodate the number of seats expected in the most likely configuration with the most frequent number of occupants.
  2. Rooms shall have a minimum clear floor area of 105 square feet (9.75 square meters) plus additional increments of 15 square feet (1.39 square meters) per person beyond five people.
Each group room shall include a staff assist device to allow staff to communicate with other staff members, internal or external, when assistance is needed.
At least one door into a group room shall swing out or be double-acting.
Where the safety risk assessment indicates the need for an observation room in the facility, a room with a minimum clear floor area of 80 square feet (7.43 square meters) shall be provided.
A2.11-3.2.6 Observation room. Observation rooms are intended for staff monitoring of clients undergoing testing or specialty therapeutic modalities. Observation may occur from an adjacent room with a separate entrance for evaluators to observe behind a one-way vision panel or via use of a camera that permits staff to observe and evaluate clients from a remote location.
Where the security risk assessment indicates the need for a seclusion room in the outpatient psychiatric center, a room that meets the requirements in this section shall be provided.
A2.11-3.2.7 Seclusion room
  1. This space is intended for patients requiring security and protection.
  2. Guidance for seclusion room design is available in International Association for Healthcare Security & Safety, Security Design Guidelines for Healthcare Facilities: 02.03 Behavioral/Mental Health Areas.
  1. Capacity. Each room shall serve only one patient.
  2. Location
    1. The room(s) shall be located to permit direct observation from outside the room.
    2. Where more than one is provided, seclusion rooms shall be permitted to be grouped together.
  3. Seclusion rooms shall be accessed by an anteroom or vestibule that also provides access to a toilet room.
*(1)  Seclusion rooms shall have a minimum clear floor area of 60 square feet (5.57 square meters) with a minimum wall length of 7 feet (2.13 meters) and a maximum wall length of 11 feet (3.35 meters).
(2)  Where a room for restraining patients is provided, it shall have a minimum clear floor area of 80 square feet (7.43 square meters).
A2.11-3.2.7.2 (1) The limit on wall length is included to address two issues: (1) to prevent a patient from being able to make a "running start" attack on a window, door, or staff member and (2) to limit the space in which a patient can try to avoid staff if a "takedown" becomes necessary.
Seclusion rooms shall be designed and constructed to avoid features that enable patient hiding, escape, injury, or suicide.
(1)  Architectural details
(a) The walls, ceiling, and floor of the seclusion room shall be designed to withstand direct and forceful impact.
(b) Minimum ceiling height shall be 9 feet (2.74 meters).
(c) Doors
(i) Door openings shall have a minimum clear width of 44 inches (1.12 meters).
(ii) The entrance door to the seclusion room shall swing out.
*(iii) Doors shall permit staff observation of the patient through a view panel, while also maintaining provisions for patient privacy. The view panel shall be fixed glazing with polycarbonate or laminate on the inside of the glazing.
(d) Seclusion rooms shall not contain outside corners or edges.
(2)  Building systems
(a) All items in the room, including but not limited to lighting fixtures, sprinkler heads, HVAC grilles, and surveillance cameras, shall be tamper-resistant and designed to prevent injury to the patient.
(b) Electrical switches and receptacles are prohibited in the seclusion room.
A2.11-3.2.7.5 (1)(c)(iii) Visual patient privacy may be obtained using elements such as exterior curtains, blinds, electronic shading of windows, and cameras.
Where a quiet room is provided, it shall meet the requirements in this section.
A2.11-3.2.8 Quiet room
  1. Time in a quiet room can be a therapy for clients experiencing personal conflicts, agitation, episodic mental disturbances, or similar conditions that require a quiet, multi-sensory, low-stimulation, positive distraction space. Some organizations have also found that agitated or stressed staff have benefited from having a quiet room available. (An example of a quiet room or "time out" room that includes positive distractions is a Snoezelen room, a controlled multi-sensory environment.)
  2. Consideration should be given to locating the quiet room to permit direct observation from outside the room.
The quiet room shall have a minimum clear floor area of 80 square feet (7.43 square meters).
  1. A toilet room shall be adjacent to the quiet room.
  2. This toilet room shall be permitted to be shared by residents using other activity spaces.
*(1)  Application
(a) Where electroconvulsive therapy (ECT) is provided in the facility, the requirements in this section shall be met, with the exception noted in paragraph (1)(b) below.
(b) All the requirements in this section shall be permitted to be accommodated in a procedure room or an operating room in a medical office setting or an outpatient surgical facility. See sections 2.1-3.2.2 (Procedure Room) and 2.1-3.2.3 (Operating Rooms) for requirements.
(2)  Size, location, and layout. The size, location, and configuration of the ECT treatment, recovery, and support areas shall reflect the type of patients to be treated and the projected volume of patients.
A2.11-3.2.9.1 (1) Equipment used in this treatment modality may be portable and can be used in a variety of medical facilities, provided the minimum requirements in this section are met.
  1. The ECT treatment area shall be permitted to be a single treatment room or a suite of rooms.
  2. ECT treatment room
    1. Space requirements. Each ECT treatment room shall have a minimum clear floor area of 200 square feet (18.6 square meters) with a minimum clear dimension of 14 feet (4.27 meters).
    2. Hand-washing station. A hand-washing station shall be provided in accordance with Section 2.1-3.8.7 (Hand-Washing Station).
    3. Documentation area. Accommodations for written or electronic documentation shall be provided.
Where ECT services have low-volume throughput, use of the ECT treatment room for pre-treatment patient care and post-treatment recovery shall be permitted.
  1. Pre-treatment patient care area. Where a pre-treatment patient care area is provided, the number and size of patient care stations shall be determined by the following:
    1. Number of ECT treatments performed
    2. Anticipated staffing levels
  2. Recovery area. Where a recovery area is provided, the number and size of patient care stations shall be determined by the following:
    1. Number of ECT treatments performed
    2. Types of anesthesia used
    3. Average recovery periods
    4. Anticipated staffing levels
  3. Hand-washing station(s). Where a pre-treatment or recovery area is provided, see Section 2.1-3.8.7 (Hand-Washing Station) for hand-washing station requirements.
  • (1) — (10) Reserved
  • (11) Emergency equipment storage
  • (a) Space shall be provided in the ECT treatment area for storage of emergency equipment such as a CPR cart.
  • (b) This emergency equipment storage space shall be permitted to serve more than one ECT treatment room.
Where waiting areas and patient toilet rooms are provided, their number and size shall be determined by the following:
  1. Number of ECT treatments performed
  2. Average recovery periods
  3. Anticipated staffing levels
See Table 8.1 in Part 3 (ANSI/ASHRAE/ASHE 170: Ventilation of Health Care Facilities) for ventilation requirements for an ECT treatment room.
An emergency electrical source shall be provided in the ECT treatment room and in the recovery area, where one is provided.
  1. See Table 2.1-2 (Station Outlets for Oxygen, Vacuum, Medical Air, and Instrument Air Systems in Outpatient Facilities) for station outlet requirements.
  2. All medical gases used shall meet the requirements of NFPA 99: Health Care Facilities Code.
Nurse call devices shall be provided in accordance with the requirements in Table 2.1-3 (Locations for Nurse Call Devices in Outpatient Facilities).
  1. Provisions shall be made for removal or covering of call buttons.
  2. All hardware shall have tamper-resistant fasteners.
Where a nurse station is provided, see Section 2.1-3.8.2 (Nurse Station) for requirements.
A multipurpose room(s) shall be provided for conferences, meetings, and health education. Use of a group room(s) for these purposes shall be permitted.
One multipurpose room shall be permitted to serve primarily for staff use, but it shall also be accessible to the public as needed.
See Section 2.1-3.8.8 (Medication Safety Zones) for requirements.
Location of a kitchenette(s) by the large group room(s) shall be permitted.
See Section 2.1-3.8.11 (Clean Workroom or Clean Supply Room) for requirements for clean storage.
See Section 2.1-3.8.12 (Soiled Workroom or Soiled Holding Room) for requirements for soiled holding.
Wheelchair storage space shall be provided in accordance with Section 2.1-3.8.13.3 (Wheelchair storage and parking space).
Staff lounge and toilet room shall be provided in addition to and separate from public and patient facilities.
These staff facilities shall be permitted to be shared with other clinic(s) in the same building.
See Section 2.1-5.2.1 (Waste Collection and Storage Facilities) for requirements.
An environmental services room shall be provided in accordance with Section 2.1-5.3.1 (Environmental Services Room).
Where engineering services are provided, see Section 2.1-5.4 (Engineering and Maintenance Services) for requirements.
Public areas shall be provided in accordance with Section 2.1-6.2 (Public Areas) as amended in this section.
Entrances shall be secured at least at the outpatient psychiatric center.
Where entrance lobby and/or elevators are shared with other tenants, travel to the outpatient psychiatric center shall be direct and accessible. Except for passage through common doors, lobbies, or elevator stations, patients shall not be required to go through other occupied areas or outpatient service areas.
A reception and information counter or desk shall be provided in accordance with Section 2.1-6.2.2 (Reception).
The reception/information counter or desk shall be located to allow visual observation of the entrance to the outpatient psychiatric center and shall be immediately apparent from that entrance.
The waiting area for patients and escorts shall be under staff control.
Where the outpatient psychiatric center has a dedicated pediatrics service, a separate, controlled area for pediatric patients shall be provided.
Each outpatient psychiatric center shall make provisions to support administrative activities, filing, and clerical work as appropriate. Administrative areas shall include the following:
A2.11-6.3 Administrative areas. See Section 2.1-6.3 (Administrative Areas) for more details.
Space(s) for private interviews shall be separate from public and patient areas.
A2.11-6.3.2 Interview spaces. Interviews may take place in an office or consultation room if the program so indicates.
Office(s), separate and enclosed, with provisions for privacy, shall be provided.
Clerical space or rooms for typing and clerical work shall be separated from public areas to ensure confidentiality.
For requirements regarding medical records, see Section 2.1-6.3.5 (Medical Records).
Office supply storage (closets or cabinets) shall be provided.
The level of patient safety and security shall be set by the governing body in the functional program.
Observation of all public areas, including corridors, shall be possible.
This can be accomplished by electronic surveillance if it is not obtrusive.
Niches and hidden areas in corridors shall be prohibited.
The standards set forth in Section 2.1-7.2 (Architectural Details, Surfaces, and Furnishings) shall be met as amended in this section:
Where the behavioral and mental health portion of the safety risk assessment identifies suicide risk or staff safety concerns:
  1. Ceilings, walls, floors, windows, etc., shall be tamper-resistant in patient treatment areas.
  2. Any rods, doors, grab bars, handrails, etc., shall be constructed so they do not allow attempts at suicide and cannot be used as weapons.
Cubicle curtains and draperies shall not be used where the safety risk assessment clearly identifies them as a safety risk.
Doors to patient toilet rooms in outpatient psychiatric facilities shall be permitted to have hardware that allows staff to control access.
See Section 2.1-8.3 (Electrical Systems) for requirements.
See Section 2.1-8.4 (Plumbing Systems) for requirements.
See Section 2.1-8.5 (Communications Systems) for requirements.
See Section 2.1-8.6 (Fire Alarm System) for requirements.
See Section 2.1-8.7 (Elevator System) for requirements.
Linked Resources
P
P Premium Feature

This feature is included in the premium subscription. Visit the feature page to learn more.

Learn More
Code Compare
P
Code compare is not available for this code.
Bookmarks
P
P Premium Feature

This feature is included in the premium subscription. Visit the feature page to learn more.

Learn More
Amendment Styling
P
P Premium Feature

This feature is included in the premium subscription. Visit the feature page to learn more.

Learn More