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Why The FGI Guidelines Are Important

Kathy Griffel

Written by Kathy Griffel, Director of Healthcare at Mannington Commercial
Feb 25, 2021

Q&A With Facilities Guidelines Institute (FGI) Leaders


If you have ever been involved in designing, building, maintaining or operating a healthcare facility, you know it is a staggering task, filled with a myriad of steps and considerations. You may also know there’s an organization dedicated to creating and maintaining guidance for the planning, design, and construction of all types of healthcare environments. 


As a flooring manufacturer leading the industry in healthcare flooring, we wanted to sit down with the Facilities Guidelines Institute (FGI) and get some questions answered for you.


Two members of  FGI spoke with Mannington Commercial about their process, publications and available resources to help healthcare specifiers work from a strong foundation of accurate, viable information. 


Kathy Griffel:

Today we're joined by two key experts from the Facility Guidelines Institute, and we're going to share some knowledge with you about FGI and the Guidelines themselves. We have Doug Erickson, CEO of the Facility Guidelines Institute, who has more than 40 years of experience with FGI and various other industry organizations. He's really the master guru of building codes and information and is a featured speaker at state and national conferences. He is a founding board member, has held leadership positions with FGI since formed in 1998, and has been involved with the Guidelines since 1978. 


We're also joined today by Yvonne Chiarelli, who's an associate editor for FGI. Yvonne works with the FGI Health Guidelines Revision Committee and is currently working with the hospital document group. She also is involved with authors and groups to develop supplemental white papers for the Beyond Fundamentals digital library. We're fortunate to have both of these specialists with us today to talk about FGI. 


What exactly is the Facility Guidelines Institute? 

Doug Erickson, CEO of FGI:

Well, since I was one of the founding members, I will certainly answer that question for you. FGI is a 501(c)(3) not-for-profit organization formed in 1998. We have a board of directors made up of a multidisciplinary group of individuals such as physicians, architects, engineers, owners. We're really here to be the guiding principle as to how hospitals, outpatient facilities, nursing homes and residential care facilities are planned, designed and constructed. 


However, our roots go back further than that to when the Reagan administration deregulated the minimum construction standards that were being applied by the Public Health Service. A few of us went to Washington D.C., and asked if we could keep the document going.


They agreed to give us the content and the intellectual property. From there we established the Guidelines for Design and Construction documents for healthcare facilities. They've gone from having AIA as the publisher back in 1985/86,  92/93,96/97, 2001, 2005 to ASHE publishing the 2010 and 2014  and now, of course, FGI is the developer and publisher of all future Guidelines.


FGI Guidelines-All three



Yvonne, why are the Guidelines important for designers and specifiers to reference?

Yvonne Chiarelli, associate editor of FGI:

It's really the fundamental book that people need to use when they're planning and designing healthcare facilities of any kind. They're important because federal agencies, states and local jurisdictions adopt the Guidelines as law and apply it as a standard against which to evaluate building projects. 


States might include the Guidelines in their laws partially or in its entirety, or where it is not adopted, some states will allow use of the Guidelines as an alternate path to compliance. The Guidelines provide the minimum requirements with an appendix that includes additional guidance such as best practices or examples. We don’t want to stymie good design creativity but need to establish the baseline minimum requirements for safe and efficient care of patients and residents .



In the healthcare arena, the Guidelines cover a variety of types of healthcare construction, right Doug?



Absolutely. We have Guidelines for hospitals, outpatient facilities and residential care facilities. Within each one of those documents are chapters addressing specialty care such as children's hospitals or behavioral health facilities. For outpatient settings, there are private offices, ambulatory surgical facilities, infusion centers. Then in residential we'll go from nursing homes to assisted living onto adult daycare and others. There’s a wide breadth of types of facilities covered by the Guidelines.


BioSpecMD_Bisque_ToastedSesame_NewNavy_Inova_16_A_GalleryImage (1)-min

Inova Women's Hospital - BioSpec MD - Bisque, Toasted Sesame and New Navy 



What are some examples that the Guidelines cover if I'm designing a hospital facility?



Well, we provide guidance starting from the early planning phases of the project, for example bringing together a multidisciplinary team to bring the owners’ vision of service to life. We call out different types of design considerations addressing issues such as sustainability, patient handling, acoustics, lighting or accommodating different types of patients and services.



Yvonne, you're so right. We start at the very beginning of that new project. We have two elements in our Guidelines: one is the functional program, and the other is the safety risk assessment. From a Mannington Commercial perspective, one of the areas we highlight is the type of surfaces to be used to address fall prevention, durability and resilience of material. The types of products designed into a new facility are evaluated upfront in the planning process.



There are things codes might cover such as the exact size a certain type of room might be — for example, an operating room. But I also hear you saying the codes might also go into some best practices about selection of finished materials and some options that designers should consider. 



That's right, and to take it from the planning phase to consider the specifics for your particular project you're going to look into different facility types and use the literal requirements for each one, such as the application and the room sizes. What are the space requirements? What needs to be in a room? The Common Elements chapter organizes broad design requirements that apply to most types of healthcare spaces including architectural details like surfaces and flooring, as well as how the building systems affect the building design.



Are the Guidelines divided up so they're easy to reference and easy to find some of this information? Is there a key to how the Guidelines is organized that helps specifiers find what they're looking for?



Yes. We've got our general and pre-design chapters upfront, and then there are chapters for the different types of facilities For example, in the Hospital Guidelines we cover hospital types such as  behavioral health, children's, and rehab hospitals. In the Outpatient Guidelines you might also have an outpatient surgical center, infusion center or endoscopy. In the Residential Guidelines you might be working on a project that's assisted living or a nursing home. It's organized in such a way to do your upfront work, then look at your specific facility type, and then where necessary, you look at those common elements that are referenced. All the references are built right in.



The Guidelines have some appendices that I think are very useful with some information that's a bit more in depth. What's some of the information that can be covered in an appendix versus the guideline itself?



Well, remember that the Guidelines content is what we consider fundamental. That means you cannot go below those stated requirements. However, in the appendix, we can stretch a bit and look at best practices, make recommendations for going above that minimum requirement, give references to other documents and explain why we wrote what we did. Three things that I would consider a takeaway on the appendix: we can introduce some best practice, we can add reference material, and we can also insert explanatory information as to why we wrote the requirement the way we did.



Doug and Yvonne, thank you so much for sharing this great information. By establishing minimum standards as well as offering best practice tips, the Guidelines are clearly critical for the ever-changing world of healthcare design. Mannington Commercial is looking forward to sharing more of your thoughts on how the Guidelines are used by each state.
Stay tuned for Part 2 next week. 




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