Adopts Without Amendments:

FGI Outpatient, 2018

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 facilities or portions thereof where endoscopy procedures are performed.
A2.9-1.1.1 Endoscopy is performed without anticipation of overnight patient care.
In addition to the standards described in this chapter, the endoscopy facility shall meet the standards in Part 1 of these Guidelines as amended in this section.
Requirements in Chapter 2.1, Common Elements for Outpatient Facilities, shall apply to endoscopy facilities as cross-referenced in this chapter.
The endoscopy procedure suite shall be divided into the following major functional areas:
Procedure room(s)
Endoscope processing room(s)
Pre- and post-procedure patient care area(s)
The endoscopy procedure suite shall be designed to facilitate movement of patients and personnel into, through, and out of defined areas in the suite.
See Section 2.1-2 (Accommodations for Care of Patients of Size) for requirements.
Where an examination room is provided for examination of patients, medical consultation, and communication with patients and their families/legal guardians, it shall meet the requirements in sections 2.1-3.2.1.2 (2) (Single-patient examination room-Space requirements) and 2.1-3.2.1.2 (3) (Room features). This room shall be permitted to serve multiple functions.
A2.9-3.1 An examination room used as a multifunctional space can accommodate both clinical and administrative functions. For example, if the room is used as a changing area, there must be enough space for the exam table/recliner/stretcher and the ability to secure medical supplies. Another example would be using the room as private interview space for the business area (to discuss insurance and billing); this would require the space to accommodate security for supplies and equipment, access from both clinical and public areas, and restricted access to or locking of doors.
A2.9-3.2 Provisions for patients with airborne infectious diseases. Where procedures are to be performed on persons known to have or suspected of having airborne infectious disease, these procedures should be performed only in a room meeting airborne infection isolation (AII) ventilation requirements or in a space using local exhaust ventilation. Where the procedure needs to be performed in an operating suite, follow recommendations outlined in the CDC "Guidelines for Environmental Infection Control in Health-Care Facilities" or the CDC "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings."
The endoscopy procedure room shall meet the requirements in Section 2.1-3.2.2 (Procedure Room) as amended in this section.
Each endoscopy procedure room shall have a minimum clear floor area of 180 square feet (16.73 square meters).
Room arrangement shall permit the following minimum clearances around the gurney/table:
  1. 5 feet (1.53 meters) at each side
  2. 3 feet 6 inches (1.07 meters) at the head and foot
Emergency communication systems shall incorporate push activation of an emergency call switch.
Pre- and post-procedure patient care area(s) shall be provided in accordance with Section 2.1-3.7 (Pre- and Post-Procedure Patient Care) and the additional requirements in this section.
Accommodations for written and/or electronic documentation shall be provided in pre- and post-procedure patient care area(s).
A2.9-3.3.2 See appendix section A2.1-3.8.3 (Documentation area) for recommended documentation area features.
A nurse or control station that meets the requirements in Section 2.1-3.8.2 (Nurse Station) shall be provided.
The nurse or control station shall be located to permit visual observation of all traffic entering the patient care and diagnostic areas.
See Section 2.1-3.8.8 (Medication Safety Zones) for requirements.
A soiled workroom or soiled holding room that meets the requirements in Section 2.1-3.8.12 (Soiled Workroom or Soiled Holding Room) shall be provided.
The soiled workroom or soiled holding room shall be physically separated from all other areas of the facility.
The soiled workroom or soiled holding room shall be permitted to be shared with other clinical services in the same outpatient facility.
  1. Storage room(s) shall be provided for storage of equipment and clean clinical supplies (including anesthesia equipment and supplies) used in the procedure suite.
  2. At minimum, storage room(s) for equipment and clean clinical supplies shall have a combined floor area of 25 square feet (7.62 square meters) per procedure room.
See Section 2.1-3.8.13.3 (Wheelchair storage and parking space) for requirements.
Space for emergency resuscitation equipment and supplies shall be provided adjacent to the procedure room(s) and pre- and post-procedure patient care areas in accordance with Section 2.1-3.8.13.4 (Emergency equipment storage).
Storage in accordance with NFPA 99: Health Care Facilities Code, including space for reserve cylinders, shall be provided for medical gas(es) used in the facility.
An environmental services room that meets the requirements in Section 2.1-5.3.1.2 (Environmental services room for facility-based environmental services) shall be provided exclusively for the endoscopy procedure suite.
Fluid waste disposal facilities shall be located in the endoscopy facility.
In the procedure area, a clinical sink or equivalent equipment in a soiled workroom (see Section 2.9-3.8.12) shall be permitted to meet this requirement.
In the recovery area, a toilet equipped with a bedpan-rinsing device in the patient toilet room referred to in Section 2.9-3.10.2 (Patient Toilet Room) or a separate clinical sink shall be permitted to meet this requirement.
A staff lounge shall be provided in accordance with Section 2.1-6.4.1 (Staff Lounge) in facilities having three or more procedure rooms.
These facilities shall be permitted to be shared with other clinical services.
Toilet facilities shall be immediately accessible to the staff lounge.
A staff changing area with one or more private changing rooms or areas shall be provided for staff working in the endoscopy procedure suite.
Provision of a unisex locker area with one or more private changing rooms shall be permitted.
The staff changing area shall include the following:
  1. Lockers
  2. Toilets
  3. Hand-washing stations
  4. Space for changing clothes
  5. Provision for separate storage of clean and soiled surgical attire
A patient toilet room(s) shall be readily accessible to procedure room(s) and pre- and post-procedure patient care area(s).
Patient toilet room(s) shall comply with the requirements in Section 2.1-3.10.2 (Patient Toilet Rooms).
An area shall be provided for patients to change from street clothing into patient gowns.
Patient changing shall be permitted to take place in the pre-procedure patient care area.
Provisions shall be made for securing patients' personal effects.
Laboratory spaces shall be provided in accordance with Section 2.1-4.1 (Laboratory Services).
Where endoscope processing is conducted in the endoscopy facility, an endoscope processing room(s) shall be provided as described in this section.
Where sterilization and endoscope processing will be conducted in the same space, requirements in Section 2.1-4.3 (Sterile Processing) shall be met.
The endoscope processing room shall be permitted to serve multiple endoscopy procedure rooms as long as it is readily accessible to each procedure room.
The endoscope processing room shall meet the requirements of a semi-restricted area.
The endoscope processing room shall consist of a decontamination area and a clean work area.
  1. The endoscope processing room shall be designed to provide a one-way traffic pattern of contaminated materials/instruments to cleaned materials/instruments to the mechanical processor.
  2. Entrance to the decontamination area of the endoscope processing room from the procedure room shall be permitted.
  3. Exit from the clean work area of the endoscope processing room into the procedure room shall be permitted.
  4. A minimum clearance of 3 feet (91.44 cm) shall be provided between the decontamination area and the clean work area.
The decontamination area shall be sized to accommodate the space needed for the equipment used.
The decontamination area shall contain the following:
(1)  Work counter
(2)  Hand-washing station
(3)  Utility sink(s)
(a) A two-basin sink(s) with a backsplash at least 12 inches high shall be provided.
*(b)  A single-basin sink with a backsplash at least 12 inches high shall be permitted where alternative methods for leak testing and pre-cleaning are provided.
(4)  Eyewash station. See Section 2.1-8.4.3.8 (Emergency first-aid equipment) for requirements.
(5)  Instrument air outlet or space for portable compressed air where required by the equipment used. See Table 2.1-2 (Station Outlets for Oxygen, Vacuum, Medical Air, and Instrument Air Systems in Outpatient Facilities).
(6)  Storage for decontamination supplies and personal protective equipment (PPE)
A2.9-4.3.2.2 (3)(b) Utility sinks. Soaking sink(s), rinse sink(s), automated cleaning device(s), or a combination may be required depending on the method of decontamination used.
The clean work area shall be sized to accommodate the minimum equipment space and clearances described in equipment manufacturers' guidelines.
The clean work area shall be equipped with the following:
  1. Countertop with space for equipment used
  2. Storage for supplies
  3. Instrument air outlet or space for portable compressed air where required by the equipment used. See Table 2.1-2.
Where an automated endoscope reprocessor is used, space and utility connections shall be provided for the equipment as described in the manufacturer's guidelines.
  1. Provisions for clean endoscope storage shall be provided in the clean work area or outside but adjacent to the procedure room.
  2. Where storage for endoscopes is provided in the clean work area of the endoscope processing room, it shall meet the following requirements:
    1. Storage shall be a cabinet(s) with doors.
    2. The cabinet(s) must be at least 3 feet (9.44 cm) from any sink.
    3. The cabinet(s) shall be located so staff do not have to cross through the decontamination area to access the clean scopes.
See Section 2.1-5.2 (Waste Management) for requirements.
An environmental services room shall be provided in accordance with Section 2.1-5.3.1 (Environmental Services Room).
Public areas shall be provided in accordance with Section 2.1-6.2 (Public Areas).
Interview space(s) for private interviews shall be provided.
Use of the room required under Section 2.9-6.3.4 (Multipurpose Room) as interview space shall be permitted.
At minimum, designated office space for general and individual office(s) shall be provided.
At least one private multipurpose or consultation room(s) shall be provided.
See Section 2.1-6.3.5 (Medical Records) for requirements.
Special storage, including locking drawers and/or cabinets, for the personal effects of administrative staff shall be provided.
The required minimum corridor width shall be provided in accordance with Section 2.1-7.2.2.1 (Corridor width).
Door openings shall be provided in accordance with Section 2.1-7.2.2.3 (2) (Door openings).
Floor, wall, and ceiling finishes in the endoscopy procedure suite shall be provided in accordance with Section 2.1-7.2.3 (Surfaces).
  1. All countertops and casework in the instrument processing room shall be made of materials that are impervious to staining and cleaning chemicals.
  2. Backsplashes shall be at least 12 inches high.
See Section 2.1-8.3 (Electrical Systems) for requirements.
See Section 2.1-8.4 (Plumbing Systems) for requirements.
See Table 2.1-2 (Station Outlets for Oxygen, Vacuum, Medical Air, and Instrument Air Systems in Outpatient Facilities) for requirements.
See Section 2.1-8.5 (Communications Systems) for requirements.
Where a manually operated, electrically supervised fire alarm system is installed in the facility, see Section 2.1-8.6 (Fire Alarm System) for requirements.
See Section 2.1-8.7 (Elevator Systems) for requirements.
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