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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 2023 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 (Demand factors in Section 517.22)
  • Patient care space categories
  • Independence of power sources (517.30)

There are, of course, many others, not the least of which involves emergency management.  For over 20 years our concern has been for the interdependency of water and electrical power supply to university hospitals given that many of them are part of district energy systems.

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.  (You may have to register your interest by setting up a free-access account):

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

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

Technical committees will meet in June to endorse the 2023 National Electrical Code.

Public consultation on the Second Draft closes May 31st. 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)

Second Draft Comments are linked below:

Electrical Systems (HEA-ELS)

Fundamentals (HEA-FUN)

Health Care Emergency Management and Security (HEA-HES)

NITMAM closing date: March 28, 2023

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.

"The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest" - William Osler"While we try to teach our children all about life, our children teach us what life is all about" - Angela Schwindt "The true art of pediatrics lies not only in curing diseases but also in preventing them" - Abraham JacobiGermany

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

 

 

 

Student Medical Centers

 

 

 

 

 

 

 

 

 

 

 

 

 

This facility class has many names but is similar in our approach to them: the settings that provide primary care in a visible, central service.  After the chapel, the library, the kitchen and the classroom, the on-campus medical center is a central fixture.  These clinics typically provide basic medical services primarily aimed at addressing the immediate health needs of students and sometimes staff.   These clinics are often staffed by a nurse or a small team of healthcare professionals such as nurse practitioners or physician assistants.

  • Services may include first aid, basic medical care (such as treating minor injuries and illnesses), immunizations, health screenings, and sometimes mental health counseling.
  • These clinics are often staffed by a nurse or a small team of healthcare professionals such as nurse practitioners or physician assistants. In some cases, a physician may be available on a part-time basis.
  • These clinics are usually small and may be located within or near the school premises. They typically have limited space and equipment compared to hospitals.

Access to school-based clinics is often limited to students and staff during school hours. They may not be open during weekends, holidays, or outside of regular school hours.

University of Michigan Health Service: Reproductive Health

University of Vermont: Primary Care at Student Health Services

University of North Dakota Student Health Services

University of Chicago Student Sexual Health

University of California System Abortion Services

During today’s open door session we examine the literature relevant to making this facility class safer, simpler, lower-cost and longer-lasting in the links below, including open public consultation close dates:

Health 400 | OB-GYN

Healthcare Occupancies

Healthcare Facilities Code

Design & Operation of Health Care Facilities

Gallery: University-Affiliated Healthcare Enterprises

Smart Medical Campus Power

 

Health 400 | OB-GYN

National Center for Health Statistics: Birth Data Files

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.  Because of the complexity of the topic we break down our coverage:

Health 200.   Survey of all relevant codes, standards, guidelines and recommended practices for healthcare settings.

Health 400.  All of the above with special consideration needed for obstetrics, gynecological and neonatal clinical practice and research.

Today we confine our interest to systems — water, power, telecommunication and security; for example — that are unique to campus-configured, city-within-city risk aggregations.  Electrotechnologies (voltage stability, static electricity control, radio-interference, etc.) in these enterprises are subtle, complex and high risk.  Sample titles from legacy best practice literature in this domain are listed below:

American College of Obstetricians and Gynecologists: Levels of Maternal Care

Provision of Care, Treatment, and Services standards for maternal safety

Since our interest lies in the habitable spaces for these enterprises we usually start with a scan of the following titles:

International Building Code Section 407 (Institutional Group I-2) identifies requirements specific to healthcare settings, covering aspects such as fire safety, means of egress, and smoke compartments. Maternity and obstetric facilities within hospitals fall under this classification.

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

ASHRAE 189.3: Design, Construction and Operation of Sustainable High Performance Health Care Facilities

Relevant Institute of Electrical and Electronic Engineers research

Towards Deeper Neural Networks for Neonatal Seizure Detection

A System to Provide Primary Maternity Healthcare Services in Developing Countries

Deep Learning for Continuous Electronic Fetal Monitoring in Labor

Reorganizing of University Hospital of Oran’s operating theatre: Simulation approach

Finally, we collaborate with the IEEE E&H Committee on the following IEC committee projects from IEC/TC 62 Electrical equipment in medical practice:

– Common aspects of electrical equipment used in diagnostic imaging equipment

– Equipment for radiotherapy, nuclear medicine and radiation dosimetry

– Electromedical equipment for neonatal care

 

More

Journal of Healthcare Management Standards: Operational Resilience of Hospital Power Systems in the Digital Age

Health Insurance Portability and Accountability Act (HIPAA)

Health care cost as percentage of Gross Domestic Product for six representative nations.

Association of Academic Health Centers

International Conference on Harmonization: The ICH guidelines provide guidance on the development of pharmaceuticals and related substances, including clinical trials, drug safety, and efficacy.

Animal Welfare Act and the Institutional Animal Care and Use Committee

Good Laboratory Practice: GLP is a set of principles that ensure the quality and integrity of non-clinical laboratory studies. It ensures that data generated from non-clinical laboratory studies are reliable, valid, and accurate.

International Code Council Representation of Interests

University of Chicago

OB-GYN Welcome

Gallery: University-Affiliated Healthcare Enterprises

The main building of the University of Minnesota Medical Center was established in 1997 through a merger with University Hospitals and Clinics and Fairview Health Services.  It has approximately 1300 beds.

Standards Minnesota

Weddings

“Marriage is a duel to the death

which no man should decline”

— G.K. Chesterton

“Wedded” 1882 Lord Frederic Leighton

…”Two are better than one, because they have a good return for their labor.

For if one falls down, his companion can lift him up;

but pity the one who falls without another to help him up!…

– Ecclesiastes 4:9

University of Michigan Botanical Gardens

Vanderbilt University | Davidson County Tennessee

University of Rochester New York

University of Minnesota | Hennepin County

 

Oxford University

University of Chicago | Cook County

 

Vanderbilt University | Davidson County Tennessee

 

Saginaw Valley State University | Saginaw County Michigan

More

“Therefore a man shall leave his father and his mother and hold fast to his wife, and they shall become one flesh” — Genesis 2:24

Sacred Spaces

Sacred Space Standards

International Building Code §303.3 Assembly Group A-2 

Evensong “How Do You Keep the Music Playing?”

 

Evensong “A Boy and A Girl”

The University Academic Choir was founded in 1948 and has a wide-ranging repertoire that includes classical, folk, and sacred music.  The choir is also involved in promoting the cultural heritage of Poland and building cultural connections with other countries around the world.

Eric Whitacre: Original poem Octavio Paz

History of Western Civilization Told Through the Acoustics of its Worship Spaces

Polska

Cocoa: Food of the Gods

Rijksuniversiteit Groningen

International Cocoa Organization


Nederland

“Love Bade Me Welcome”

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Shrove Tuesday

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