2021 ASHE PDC Summit Recap

For those who couldn’t attend the virtual Planning, Design & Construction Summit hosted by the American Society for Health Care Engineering (ASHE PDC), below is a brief recap of some of the themes and hot topics that are, or will, be impacting design and construction in the healthcare setting: COVID-19 Several presentations were given, including one of our own, that looked at post-pandemic design and being prepared for future infectious diseases.

• Short and long-term solutions that can impact patient traffic and flow through functional layout/design are available. Implementing some of these design features may also support other events like patient surge.
• It was also noted that simple changes in policy may impact infection prevention more than small-scale solutions like upgrading an HVAC system or installing additional filtration.

FGI 2022 There were several presentations that covered many of the major changes coming in the 2022 edition of the FGI Guidelines. A great benefit of these presentations was learning the “why” behind the changes.

1. Acoustics.
   • There will be a heavy acoustic focus in the residential and outpatient guidelines moving forward. The hope is that this will create better alignment with hospital guidelines. While Henderson has a presentation focusing on acoustics in the hospital, we will be updating this shortly to align with upcoming changes in the 2022 FGI Guidelines.
2. Emergency Department.
   • Freestanding emergency care facilities guidelines will now be found in the outpatient guidelines only.
   • The definition of exam/treatment has been revised. Previously, both were defined separately, but are now combined into one definition for spaces that do not require the controls of a procedure room.
   • Arrival/entry point shall include video surveillance and a duress alarm system (where entrances may be locked). This change is a direct result of “Laura’s Law.”
   • Low-Acuity treatment area is a newly defined space to allow for treating patients with less urgent needs in a bay or cubicle within the emergency department.
   • There will be four types of spaces defined for providing psychological care and treatment – secure holding room, flexible secure treatment room, behavioral and mental health treatment room, and seclusion room. These new requirements will give facilities options for risk mitigation strategies including direct observation, restraint, or a combination of both.

Rural Health

• FGI pulled together a committee to look at rural health and the current challenges that exist including access to services, demographic shift (aging population with more acute and chronic ailments than in urban/suburban settings), staffing, resources, infrastructure issues, and how the pandemic accelerated some of these challenges. 2022 FGI Guidelines will define a “small hospital” as a facility with 35 beds or less.
• Centers for Medicare & Medicaid Services (CMS) is also supporting rural health by defining a new provider type – Rural Emergency Hospital (REH) – that will take effect in January 2023. These facilities must have an annual length of stay under 24 hours and a staffed emergency department 365/24/7. It is also possible that critical access hospitals (CAH) may switch to this REH program and back to a CAH. Under this new program, which will include new Conditions of Participation (COPs), the REH facilities will receive a different reimbursement program. Stay tuned for more information as this continues to develop.

Behavioral Health The concept of whole health, including mental and behavioral health, isn’t new. However, these specific care needs have been accelerated by the COVID-19 pandemic. Beyond some of the topics that are addressed in the 2022 FGI Guideline updates, presentations addressed the growing demand for these services in the Emergency Department as well as in the outpatient setting. Many parts of the country are seeing increased wait times for care in both inpatient and outpatient settings as well as the need to travel further for care. Because of these challenges, there is a bigger focus on empathetic design to allow for the best care as well as flexibility of spaces to address current needs. This is all taking place with an eye to the future as virtual visits, new technologies, and care methods are developed.   As you can see, there was a mass amount of incredibly relevant and important information covered. To say that healthcare has a lot going on right now would be an understatement. If you have questions about any of the above or just want to talk through these topics with someone, we’re happy to help. This summit was great, but we can’t wait to get back to seeing you all in person again soon. Look out for Team Henderson at the ASHE Annual Conference in Nashville this August.