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Health

Today we break down regulations, codes, standards and open-source literature governing the safety and sustainability of university-affiliated medical research and healthcare delivery facilities.   In large measure, the safety and sustainability agenda of the university-affiliated healthcare system infrastructure coincides with the private sector.   Accordingly, we confine our interest to systems — water, power, telecommunication and security; for example — that are unique to campus-configured, city-within-city risk aggregations.

We usually start with a scan of the following titles:

International Building Code (with particular interest in Section 308 Institutional Group I)

K-TAG Matrix for Healthcare Facilities

NFPA 70 National Electrical Code Article 517

NFPA 99 Healthcare Facilities Code

NFPA 101 Life Safety Code Chapters 18 & 19

ASHRAE 170 Ventilation of Healthcare Facilities

Some of the content in the foregoing links will need a refresh.

We will thumb through the titles published by HL7 and NSF International — both Ann Arbor-based organizations.  A surprising number of medical data companies are domiciled in Ann Arbor; not far from our own offices on State Street.   We will also see if any bills and resolutions introduced into the 117th Congress will make into public law.

 

As covered in previous posts, the original University of Michigan standards enterprise was one of the founding members of what has become ISO/TC 304 Healthcare organization management — following the lead set by Lee Webster at the University of Texas Medical Branch.  Since last month’s colloquium ISO TC/304 there has been a fair measure of the usual back-and-forth that we will cover in today’s colloquium.  We will examine the ideas in play in the links below today and try to organize them ahead of balloting:

ISO/TC 304 Catalog status

Legacy Workspace  (N.B. We are still in the process of uploading content onto the new University of Michigan Google Site facility)

2021-03-12_PC-Decision-Timeline-Extension-Virtual Meetings_EN

Open to everyone.  Use the login credentials at the upper right of our home page.


Standing Agenda / Healthcare Facilities Monthly

 

 

 

Healthcare Organization Management

“Une leçon clinique à la Salpêtrière” 1887 André Brouillet

This committee does not yet have a dedicated workspace on an ISO host and administered by the US Technical Advisory Group Administrator —Ingenesis.  The American National Standards Institute — the Global Secretariat for ISO — does not provide content management systems for its US Technical Advisory Groups.  Because of the nascent committee, inspired by the work of Lee Webster at the University of Texas Medical Branch needed a content management system, we have been managing content on a Google Site facility on a University of Michigan host since 2014.

Earlier this spring, the University of Michigan began upgrading its Google Sites facility which requires us to offload existing content onto the new facility before the end of June.  That process is happening now.  Because of this it is unwise for us to open the content library for this committee publicly.  Respecting copyright, confidentiality of ISO and the US Technical Advisory Group we protect most recent content in the link below and invite anyone to click in any day at 15:00 UTC.  Our office door is open every day at this hour and has been for the better part of ten years.

There has been significant standards setting action since last month’s meeting which we will discuss during today’s colloquium.  Eventually, the US TAG will have a workspace that will replace the original University of Michigan and University of Texas Medical Branch workspace.

 

[Issue 14-99]

Contact:  Lee Webster (lswebste@utmb.edu, lwebster@ingenesis.com), Mike Anthony (mike@standardsmichigan.com), Jack Janveja (jjanveja@umich.edu), Richard Robben (rrobben1952@gmail.com), James Harvey (jharvey@umich.edu), Christine Fischer (chrisfis@umich.edu), Dr Veronica Muzquiz Edwards

Category: Health, Global

Workspace / ISO 304 Healthcare Administration

More

ISO Focus Special Issue on Healthcare

ISO/TC 48 Laboratory equipment

ISO/TC 212 Clinical laboratory testing and in vitro diagnostic test systems

ISO/TC 198 Sterilization of health care products

 

Syllabus

“October” | George Inness (1825-1894)


Autumn Syllabus Week 43 | October 25-31

Our daily colloquia are typically doing sessions; with non-USA titles receiving priority until 16:00 UTC and all other titles thereafter.  We assume policy objectives are established (Safer-Simpler-Lower-Cost, Longer-Lasting).   Because we necessarily get into the weeds, and because much of the content is time-sensitive and copyright protected, we usually schedule a separate time slot to hammer on technical specifics so that our response to consultations are meaningful and contribute to the goals of the standards developing organization and to the goals of education community real assets.

We have been doing it this way every day since 2013 and this way works.  We are respectful of the intellectual property of standards-developing organizations.  We are attentive to requirements for confidentiality; especially in the case of unstable (draft) titles.

Keep in mind that the American National Standards Institute administers a relatively small part of standards-setting in the United States.  (Click here for a complete list; updated monthly.  A great deal of ANSI resources are devoted to supporting members that run “conformance shops” essential to safe and fair trade.  Other standards setting is done by governments, open-source, and other ad hoc consortia.

The culture of the standards-setting domain in every nation rests upon the culture of conformance.  “Standards are the seed corn for conformance revenue” we are fond of saying and most of the expertise in the standards setting domain rests with people who make a living making sure others conform to the standard; whatever that standard may be.  Conformance (product testing, installation certification, periodic re-commissioning and audits, etc.) is where the money is so we should not be surprised at the degree to which the user-interest (represented by the third gray column in our logo) is outnumbered.

That much said, having the global standards system is better than not having one at all.  This system places a check on oligarchies that make central governments grow.

 

0. Leviathan.

H.R. 5103: Quality Higher Education Act of 2021

S. 2911: American Broadband Buildout to Eliminate America’s Digital Divide Act of 2021

H.R. 4819: National Nuclear University Research Infrastructure Reinvestment Act of 2021

S. 2905: University Cybersecurity Consortia Improvement Act of 2021

117

1.*  Nota Bene (Consultation close dates 30-45 days).  There is only modest similarity in the public consultation platforms of ANSI accredited standards developers.   Many of the links below will not redirect you to a coded commenting form.  Most content is time sensitive, copyright protected and technically difficult — our primary reasons for hosting daily colloquia that features the topics identified on our CALENDAR.

Open consultations from the World Trade Organization (via NIST):

Standards Coordination Office | USA WTO TBT Enquiry Point    (The above-average tranche of consultations may reflect recovery from the circumstances of the pandemic.  In other words, the proficiency of regulators and standards administrators working from home seems to gather pace. )

Open consultations the next 30-45 days from ANSI Continuous Maintenance Standard Development Organizations.  See Canadian Parliamentary Debate RE: Incorporation by Reference for enlightened discussion about short consultation periods for enforceable public safety titles

1A. AGA  Lorem ipsum

1B. ASABE (St. Joseph, Michigan).   ASABE is ANSI’s US Technical Advisory Group chair for ISO the Global Secretariat for the ISO/TC 34 Food Products.

– Tractors and machinery; US national adoption of ISO standard (November 15)

–  Six relatively stabiliized titles, among them S623.1 Determining Landscape Plant Water Demands (November 22)

1C. ASC X9   

– X9.121 Balance and Transaction Reporting Standard (BTRS) Version 3.1 (BTR3) (November 22)

1D. ASHRAE  (Owing to the speed of change in ASHRAE’s catalog, we identify only a selection.  N.B. NEW ASHRAE WORKSPACE )

Minimum efficiency requirements for low-voltage dry-type transformers

– Minimum thermal efficiency (Et) requirements for high-capacity gas-fired water heaters in new buildings.

– Standard Representation of Performance Simulation Data for HVAC&R and Other Facility Equipment

135 BACNet Data Communication Protocol for Building Automation and Control Networks (October 4)

-230P Commissioning Process for Existing Systems and Assemblies (October 25)

ASHRAE/ASHE 170 Ventilation of Health Care Facilities (October 24)

– 189.1 Standard for the Design of High-Performance Green Buildings Except Low-Rise Residential Buildings.

Content RE: walls in 5.3.5.2 now will be relocated to 90.1 (November 8)

– 90.1 Several addenda (RE: illumination) are cross cutting and require attention (November 8)

1E.  ASME  Our priority lies with the elevator, piping and boiler titles. C&S Tools:

A17.1-20XX/B44-XX, Safety Code for Elevators and Escalators (November 22)

Twenty-odd stabilized titles open for consultation until December 7.  CLICK HERE (Pages 29-34) for product titles open for consultation until December 22.

1F. ASTM

ASTM usually unloads stabilized titles in 10-100 batches with consultation periods 30-45 days.  CLICK HERE for this week’s tranche; all of them stabilized with consultation closing November 20.

Another tranche of about 50 stabilized titles have been released for consultation ending November 1st.  CLICK HERE for this week’s tranche.

1G. CTA  Lorem ipsum

1H. Green Building Initiatives   Lorem ipsum. This organization seems devoted primarily to harvesting conformance revenue from incumbent standards developers in the energy conservation domain.

1J.  HL7 (Ann Arbor Michigan).  Lorem ipsum

1K.  IES   We coordinate our response to IES consultations with the IEEE Education & Healthcare Facilities Committee.

LP-13-202x, Lighting Practice: Introduction to Resilient Lighting (October 25)

LS-1-202x, Lighting Science: Nomenclature and Definitions for Illuminating Engineering (October 25)

RP-8-202x, Recommended Practice: Design and Maintenance of Roadway and Parking Facility Lighting (October 25)

1L.  INCITS

As the US TAG to several IEC technical committees INCITS is charged with harvesting comments on (generally) stabilized IEC titles.   Consultations are released by the dozens (because of the way IEC slices its literature) and nearly impossible to review in detail.  The good news is that the titles are generally stabilized; meaning that the changes are largely administrative.  CLICK HERE to access this week’s tranche.

Stakeholders have an opportunity to participate in the development in these titles farther upstream the IEC public consultation process.  We work close coupled with several IEEE Societies on technical issues and sweep through them 4 times monthly with the IEEE Education & Healthcare Facilities Committee.

Seventeen stabilized ISO/JTC 1 titles open for consultation until December  7 (Pages 45-40).  Referred also to IEEE E&H

1M.  NEMA

MG 1 Motors and Generators (December 6)

1N.  NSF International (Ann Arbor, Michigan)

– 53 Drinking Water Treatment Units (November 15)

1P.  SAE International (Troy, Michigan ). Lorem ipsum

1Q.  TIA

The bulk of the TIA catalog for information and communications technology is product oriented.  We collaborate with the IEEE Education & Healthcare Committee on interoperability issues.

1R.  UL  Since UL is primarily a conformance organization and a nationally recognized testing laboratory, much of its catalog is product standard.

– Several titles harmonizing with IEC titles (October 25).  Referred to IEEE E&H

– 217  Standard for Safety for Smoke Alarms.  CLICK HERE Page 98 to see why we steer away from product standards but rather steer toward interoperability standards – which is not to diminish the significance of uniformity in smoke detection devices.  Fire protection engineering is as much an art as any other art that depends upon its media.  Listed here for educational purposes only ahead of Wednesday’s Prometheus colloquium.  (November 7)

2. ANSI ISO and USNC/IEC Consultations

ANSI seeks comments from US stakeholders on proposed new field of ISO technical activity for Menstrual Products.  Consultation closes November 19th
– ANSI seeks comments from US stakeholders on proposed new field of ISO technical activity for Heat Supply Networks.  Consultation closes October 29th.
– ISO/TC 304 Healthcare organization management – American National Requirements for Patient-Centered Staffing.
– ISO/TC 304 Telehealth appointment ballot closes 1 November
– ISO/CD 5741 for Pandemic Response for Temporary Medical Facility.  Comments due 19 November
– New Work Item Proposal for ISO 9001 Policing Organizations by the Standards Council of Canada.   Query Steve Cornish (scornish@ansi.org) for the prospectus.
– ISO/DIS 5472 Pandemic response (respiratory) (October 12)
ISO_DIS_5472_(E) Pandemic Response (Respiratory_ – Walkthrough Screening Station (October 12)
– ICYMI We did not submit comments on the NWIP from Svenska institutet för standarder for ISO/PC 325 .   The project covers products in growing, widespread use in education communities.  We did, however, discuss it during our Global colloquium

3USNC/IEC Consultations

– USNC/IEC Strategic Group (SG) 12: Digital Transformation and Systems Approach needs experts.

Electrical Installations for Buildings

4. Log of Proposals and Comments on Public Consultations and Federal Regulations

N.B. We are in the process of converting legacy University of Michigan workspaces that were built from Classic Google Sites to the upgraded Google Sites.  Some links may be broken during the conversion.

5. Fast Forward (Accredited, Open-Source and Consortia Consultations with close dates beyond 30-45 days)

Acoustical Society of America.  Lorem ipsum

American National Standards Institute

2020 Student Paper Competition

American Water Works Association

– C300+ product titles (October 18)

American Welding Society.   We follow but do not participate in marking up redlines at this time.   Much of the AWS catalog lie at the foundation of the curricula of many community colleges and other trade schools.  Many large research universities also have full-time welding staff.  Comments on AWA C3.7 Specification for Aluminum Brazing are due September 27th

APCO

– 1.101.4-202x, Standard for Public Safety Telecommunicators When Responding to Calls of Missing, Abducted, and Sexually Exploited Children (November 22)

ATIS

Four titles covering energy efficiency of telecommunication equipment (November 1st)

AVIXA Lorem ipsum

Builders Hardware Manufacturers Association.

A156.23 Standard for Electromagnetic Locks & Exit Locks (November 15)

Entertainment Services and Technology Association

Several titles cutting across electrotechnologies (October 26 – December 14)

FM Global.  Lorem ipsum

Healthcare Standards Institute

– HSI/ISO 5258 Standard Protocol of Drive-Through Screening Station for Infectious Disease Control (December 6)

Institute of Electrical and Electronic Engineers

Guide to Using IEEE Standard 1547 for Interconnection of Energy Storage Distributed Energy Resources | Comments Due November 14th

NEMA.  Lorem ipsum

2023 National Electrical Code Second Draft Meetings (October-ish)

IAPMO

Z124-202x, Plastic Plumbing Fixtures (November 15)

ICC Healthcare Public Comments

Final Public Comment Hearing Results on the 2021 Proposed Changes to the International Code – Group A

Licensing Executives Society.   Lorem ipsum

Laser Institute of America  Lorem ipsum

NEMA.  Lorem ipsum

National Electrical Testing Association (Portage, Michigan) Lorem ipsum

NFPA

– 45  Standard on Fire Protection for Laboratories Using Chemicals (December 6)

– 70B Recommended Practice for Electrical Equipment Maintenance (December 6)

– 140 Standard on Motion Picture and Television Production Studio Soundstages (December 6)

– 2800 Standard on Facility Emergency Action Plans (December 6)

6. Rewind

ANSI is no longer participating in ISO/TC 268/SC 2 – Sustainable Cities and Communities but seeks a US TAG to replace the NFPA; the previous US TAG.  CLICK HERE for the original University of Michigan Workspace

7. Calls & Letters

8. Corrigenda


Bermuda College | Paget Parish


International Standardization Organization Week Date

BETA: SYLLABUS UPGRADE

Healthcare Occupancies


Safety and sustainability for any facility, not just university-affiliated healthcare facilities, usually begin with an understanding of who, and how, shall occupy the built environment.  University settings, with mixed-use occupancy arising spontaneously and temporarily, often present challenges and they are generally well managed.  First principles regarding occupancy classifications for healthcare facilities appear in Section 308 of the International Building Code, Institutional Group I; linked below:

2021 International Building Code Section 308 Institutional Group I

There are thousands of healthcare code compliance functionaries and instructors; most of them supported by trade associations and most of them authoritative.   Hewing to our market discipline to track only the concepts that will affect university-affiliated healthcare enterprises only.  There are a few noteworthy differences between corporate healthcare businesses and university affiliated healthcare enterprises (usually combined with teaching and research activity) that we identify on this collaboration platform.

We collaborate closely with the IEEE Education & Healthcare Facilities Committee which takes a far more global view of the healthcare industry.  That committee meets online 4 times monthly in European and American time zones.

Finally, we encourage our colleagues to participate directly in the ICC Code Development process.  Contact Kimberly Paarlberg (kpaarlberg@iccsafe.org) for more information about its healthcare committees and how to participate in the ICC code development process generally.

 

Issue: [18-166]

Category: Architectural, Healthcare Facilities, Facility Asset Management

Colleagues: Mike Anthony, Jim Harvey, Richard Robben


LEARN MORE:

Workspace / ICC

K-TAG Matrix for Healthcare Facilities

 

Healthcare Facilities Code

“The Doctor”  1891 Sir Luke Fildes

The NFPA 99 Healthcare Facilities Code committee develops a distinct consensus document (i.e. “regulatory product”) that is distinct from National Electrical Code Article 517; though there are overlaps and gaps that are the natural consequence of changing technology and regulations.  It is worthwhile reviewing the scope of each committee:

NFPA 99 Scope: This Committee shall have primary responsibility for documents that contain criteria for safeguarding patients and health care personnel in the delivery of health care services within health care facilities: a) from fire, explosion, electrical, and related hazards resulting either from the use of anesthetic agents, medical gas equipment, electrical apparatus, and high frequency electricity, or from internal or external incidents that disrupt normal patient care; b) from fire and explosion hazards; c) in connection with the use of hyperbaric and hypobaric facilities for medical purposes; d) through performance, maintenance and testing criteria for electrical systems, both normal and essential; and e) through performance, maintenance and testing, and installation criteria: (1) for vacuum systems for medical or surgical purposes, and (2) for medical gas systems; and f) through performance, maintenance and testing of plumbing, heating, cooling , and ventilating in health care facilities.

NFPA 70 Article 517 Scope:  The provisions of this article shall apply to electrical construction and installation criteria in healthcare facilities that provide services to human beings.  The requirements in Parts II and III not only apply to single-function buildings but are also intended to be individually applied to their respective forms of occupancy within a multi-function building (e.g. a doctor’s examining room located within a limited care facility would be required to meet the provisions of 517.10)   Informational Note: For information concerning performance, maintenance, and testing criteria, refer to the appropriate health care facilities documents.

In short, NFPA 70 Article 517 is intended to focus only on electrical safety issues though electrotechnology complexity and integration in healthcare settings (security, telecommunications, wireless medical devices, fire safety, environmental air control, etc.) usually results in conceptual overlap with other regulatory products such as NFPA 101 (Life Safety Code) and the International Building Code.

Several issues were recently debated by the Article 517 technical committee during the 2020 National Electrical Code Second Draft meetings

  • The conditions under which reconditioned electrical equipment be installed in healthcare settings; contingent on listing and re-certification specifics.
  • Relaxation of the design rules for feeder and branch circuit sizing through the application of demand factors.
  • Application of ground fault circuit interrupters.
  • “Rightsizing” feeder and branch circuit power chains

There are, of course, many others, not the least of which involves emergency management.

We need to “touch” this code at least once a month because of its interdependence on other consensus products by other standards developing organizations.  To do this we refer NFPA 99 standards action to the IEEE Education & Healthcare Facilities Committee which meets online four times monthly in European and American time zones.

The transcript of NEC Article 517 Public Input for the 2023 revision of NFPA 70 is linked below:

Code-Making Panel 15 (NEC-P15) Public Input Report

Technical committees will meet in October-November to respond to public comment; on track for an August 2022 release of the 2023 NEC.

 Landing page for selected sections of the 2024 revision  of NFPA 99 are linked below:

Electrical Systems (HEA-ELS)

Fundamentals (HEA-FUN)

Health Care Emergency Management and Security (HEA-HES)

We break down NFPA 70 and NFPA 99 together and keep them on the standing agenda of both our Power and Health colloquia; open to everyone.  See our CALENDAR for the next online meeting.

Issues: [12-18, [15-97] and [16-101]

Contact: Mike Anthony, Jim Harvey, Robert Arno, Josh Elvove, Joe DeRosier, Larry Spielvogel

NFPA Staff Liaison: Jonathan Hart

Archive / NFPA 99

 

 

 

Resilience of Hospital Power Systems in the Digital Age

Fondazione Policlinico Universitario Agostino Gemelli Rome

 

Operational Resilience of Hospital Power Systems in the Digital Age

Sapienza University of Rome, Roma, Italy
Ospedale Pediatrico Bambino Gesu, Rome, Italy
Parise professional office, Italy
Cosenza Hospital District, Cosenza, Italy
University of Michigan, Ann Arbor, MI, USA

 

Abstract: An advanced guideline is required to support the design of power supply systems for the performances of service continuity and power outage resilience, which are vital for hospital power systems and strategic operational structures (SOSs). The supply sources, the power system topology, and its management are fundamental in guaranteeing the electrical resilience of the power system. There is still no standard to evaluate the adequacy of hospital power systems for natural calamities and human-made disasters and, subsequently, for the ordinary operation. The World Health Organization recognizes it as a basic problem and at this aim has to claim clearly the status of SOSs for the hospitals, recommending to safeguard and plan the full operability. The hospital power systems need a local fortified electrical structure, designed for service continuity during fault events and managed to ensure an adequate dynamic response to any emergency and maintenance needs. The importance of the business continuity management is highlighted; it has to be qualified for a permanent design with both the in-op approaches for the initial installation of the system and its life cycle operation.

CLICK HERE to order complete paper

 

S. 2997: Prohibit a COVID-19 vaccination requirement for eligibility in nutrition programs.

117th Congress Swearing In Floor Proceedings – January 3, 2021, House Chamber

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