Hospital construction/renovation guidelines promote sound control

Since its founding in 1998, the Facilities Guidelines Institute has been developing, revising, and publishing guidelines for the construction and renovation of hospitals and outpatient facilities. In 2010, it came out with guidelines that specifically addressed noise and vibration. Last year, it published guidelines for residential healthcare facilities, such as nursing homes and assisted living centers.

FGI’s guidelines have a way of insinuating themselves into state healthcare facility codes. Its call, in 2006, for single-bed patient rooms to be an “absolute” for medical, surgical, and obstetric rooms has become the standard for new hospital construction. Forty-two states have adopted FGI guidelines, in part or in full, says FGI’s CEO Douglas Erickson, FASHE, CHFM, HFDP, CHC.

The healthcare industry has largely embraced FGI guidelines. “Hospitals are pressing the AEC community to at least advise the owner about the latest guidelines, and then let the owner decide if it wants to take the leap,” says Erickson.

FGI gets about a thousand suggestions for new guidelines or revisions from the public every year, says the institute’s Chairman and President, Kurt Rockstroh, FAIA, FACHA, President/CEO, Steffian Bradley Architects & Planners. Those ideas are vetted by steering and revision committees; if accepted, they are turned into draft documents and submitted for public comment. A cost-benefits committee serves as another filter. Eventually all of FGI’s committee members vote on whether a proposal becomes a guideline. Each four-year revision cycle costs FGI about $2 million.

The 2014 revised guidelines touch on six factors that affect a hospital’s soundscape:
1. Site exterior noise
2. Acoustic finishes and details
3. Room noise levels and minimum sound coefficients for various types of rooms
4. Sound isolation and speech privacy
5. Alarms and sound-masking techniques
6. Vibration

Because FGI does not include suppliers or manufacturers on its committee, its revision cycle is not ANSI-approved, although it does follow ANSI protocols as much as possible, says Erickson. The 2018 revisions, which will be voted on by 105 committee members, are likely to include guidelines about alarm fatigue in hospitals.

Rural hospitals present unique opportunities and challenges for healthcare facility operators. Oftentimes, the infrastructure and building systems have not been updated for years and require significant improvements in order to meet today’s modern medical demands. Additionally, as these smaller, more remote hospitals are acquired by larger regional and national healthcare systems, the first step by new ownership is often to update and rehabilitate the building. But how can this be done thoughtfully, economically, and efficiently in ways that allow the engineering and facility staff to adapt to the changes? And how can the updates accurately reflect the specific needs of rural communities and the afflictions with which these areas most commonly face?