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.
The spaces needed and design requirements for each general or specialty medical services facility shall be determined by the services provided in the facility and the acuity level of the patients served.
A2.2-1.1.1 General and specialty medical services facility types. Facilities where general and specialty medical services are provided come in a wide variety of types and sizes, some extremely simple and small and others fairly complex and large. The care provider can be a single tenant in a multi-tenant building or a sole tenant, occupying the entire building. A new project for this type of facility might be simple tenant Improvement work or could be the design and construction of a new building. The medical services offered might be confined to patient care or diagnosis or include both.
Typical facility types in this category may include, but are not limited to, the following:
  1. Micro-clinics
  2. Neighborhood/storefront clinics
  3. Retail clinics
  4. Sole practitioner clinics
  5. Primary care centers
  6. Community-based clinics
  7. Physician practices
  8. Multi-specialty medical clinics/office buildings
  9. Single-specialty medical clinics/office buildings
General or specialty medical services facilities 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 general or specialty medical services facilities when cross-referenced in this chapter.
Where accommodations for care of patients of size are provided, see Section 2.1-2 (Accommodations for Care of Patients of Size) for requirements.
Where the patient care and diagnostic areas and their support areas in Section 2.1-3 (Patient Care and Diagnostic Areas) are provided in a general or specialty medical services facility, they shall meet the requirements in Section 2.1-3 as amended in this section.
At least one examination room shall be provided.
Examination rooms shall be permitted to serve as both examination and treatment spaces; see Section 2.1-3.2.1 (Examination Rooms).
Where imaging services are provided in a general or specialty medical services facility, the imaging facilities shall meet the requirements in Section 2.1-3.5 (Imaging Services) for the imaging services provided.
A clean workroom or a clean supply room shall be provided. Provision of a clean work area or a clean supply area shall be permitted to meet this requirement.
A2.2-3.8.11 Clean supply area. In a small facility, a closet would be acceptable for this purpose.
Where this space is provided for preparing patient care items, the clean workroom or clean work area shall meet the requirements in Section 2.1-3.8.11.2 (Clean workroom).
Where this space is provided only for storage and holding as part of a system for distribution of clean supplies, the clean supply room or clean supply area shall meet the requirements in Section 2.1-3.8.11.3 (Clean supply room).
A clean workroom shall be permitted to be shared with other clinical services in the same building.
A soiled holding room that meets the requirements in Section 2.1-3.8.12.3 (Soiled holding room) shall be provided.
Storage for equipment and supplies shall be provided.
A2.2-3.8.13 Operational needs and work flows should be considered in sizing and locating storage rooms or areas.
A patient toilet room(s) that meets the requirements in Section 2.1-3.10.2 (Patient Toilet Room) shall be readily accessible from examination rooms.
This patient toilet room shall be permitted to serve waiting areas.
Facilities to support laboratory procedures performed on-site shall be provided as described in Section 2.1-4.1 (Laboratory Services) and amended in this section.
At minimum, laboratory facilities provided on-site shall include space for the following:
  1. Use of the toilet room in Section 2.2-3.10.2 (Patient Toilet Room) for specimen collection shall be permitted if the toilet room is accessible without reentering the waiting room or leaving the clinical services area.
  2. Use of an examination room in Section 2.2-3.2.1 (Examination Rooms) shall be permitted for blood collection.
  1. Where specimen collection is conducted on-site, accommodations for storage of blood, urine, and other specimens shall be provided.
  2. Blood storage facilities shall meet the requirements of the Clinical Laboratory Improvements Act (CLIA) standards for blood banks.
A2.2-4.1.8.2 Storage for extended periods may require a specimen storage refrigerator for holding samples in advance of courier or testing service collection.
Where a pharmacy is included in the project, see Section 2.1-4.2 (Pharmacy Services); otherwise, see Section 2.1-3.8.8 (Medication Safety Zones) for requirements.
Where sterile processing is performed on-site, see Section 2.1-4.3 (Sterile Processing) for requirements.
Where sterile processing is performed off-site, the support areas in Section 2.1-4.3.3 (Support Areas for Outpatient Facilities Using Off-Site Sterile Processing) shall be provided as amended in this section.
Provision of an area instead of a room shall be permitted to meet the requirements in sections 2.1-4.3.3.1 (A room for breakdown...) and 2.1-4.3.3.2 (A room for on-site storage...).
Where services provided require decontamination of instruments, a room with a clinical sink or flush-type device for gross decontamination and holding of instruments shall be provided.
  1. Use of a hand-washing station shall not be permitted for this function.
  2. The room described in Section 2.1-3.8.12 (Soiled Workroom or Soiled Holding Room) shall be permitted to serve this purpose.
Where linens are used, see Section 2.1-4.4 (Linen Services) for requirements.
For facilities that receive shared or purchased materials, see Section 2.1-5.1 (Materials Management) for requirements.
See Section 2.1-5.2 (Waste Management) for requirements as amended in this section.
Location of space for a covered hamper holding non-hazardous waste and used, unsoiled linen in an alcove shall be permitted provided the stored waste does not block an egress route.
Location of storage for hazardous waste (red bag trash) and sharps shall be behind a closed door. Location of this storage in an exam room shall be permitted.
An environmental services room shall be provided in accordance with Section 2.1-5.3.1 (Environmental Services Room).
See Section 2.1-5.4 (Engineering and Maintenance Services) for requirements.
Storage room(s) for building maintenance supplies and equipment shall be permitted to be shared.
Public areas shall be provided in accordance with Section 2.1-6.2 (Public Areas).
A2.2-6.2 Seating capacity for waiting area or room. Waiting areas or rooms in general and specialty medical services facilities may require greater seating capacity than that recommended in appendix section 2.1-6.2.3.1 (Seating capacity for waiting areas or rooms) based on projected use, operational models, distance patients travel to the facility, and demographics.
Each general or specialty medical services facility shall make provisions to support administrative activities, filing, and clerical work. See Section 2.1-6.3 (Administrative Areas) for requirements.
A2.2-6.3 Conference/meeting space. Provision of space or means for conducting conferences, meetings, and health education with privacy should be considered. This space might be shared with an office, staff lounge, or exam room.
Each general or specialty medical services facility shall make provisions to support administrative activities, filing, and clerical work. See Section 2.1-6.3 (Administrative Areas) for requirements.
Support areas for staff shall be provided in accordance with Section 2.1-6.4 (Support Areas for Staff).
A2.2-6.4 Support areas for staff
  1. Staff storage. Provisions for storing valuables may be as simple as providing a locked drawer.
  2. Staff toilet room. Provision of a staff toilet room in addition to and separate from public and patient facilities may offer some operational efficiencies that should be considered.
See Section 2.1-7 (Design and Construction Requirements) for requirements.
Electrical systems in all general and specialty medical services facilities shall meet the following requirements:
Electrical system requirements in NFPA 99: Health Care Facilities Code according to the NFPA risk category (1—4) that applies to the facility type
Requirements in NFPA 70: National Electrical Code®
Automatic emergency lighting shall be provided in every facility that has a total floor area of more than 1,000 square feet (92.9 square meters) and in every facility requiring a stairway exit.
Duplex receptacles shall be available for all equipment to be used in the space.
Each examination and work table area shall be served by at least one duplex receptacle.
Plumbing and other piping systems shall meet the requirements in this section.
Systems shall comply with applicable codes and be designed to supply water at the pressure required to operate all fixtures and equipment during maximum demand.
Backflow preventers (vacuum breakers) shall be installed on water supply outlets to which hoses or tubing can be attached where required by local codes or medical equipment manufacturers.
Water temperature at hand-washing stations shall meet the requirements in Section 2.1-8.4.2.5 (4) (Water temperature).
For nurse call system requirements, see Table 2.1-3 (Locations for Nurse Call Devices in Outpatient Facilities).
See Section 2.1-8.6 (Fire Alarm System) for requirements.
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