In March, the 2014 healthcare facility guidelines will be available. And, for the first time ever, there will be two volumes—one for hospitals and outpatient facilities, and one for residential health, care, and support facilities.

This is a significant improvement to the guidelines, and one I’m sure will be welcomed by the healthcare, design, and construction industry.

Published by the Facility Guidelines Institute (FGI), the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities and the new Guidelines for Design and Construction of Residential Health, Care, and Support Facilities have been four years in the making. Actually, the guidelines have been more than 60 years in the making, since general standards were first introduced by the federal government in 1947 to help implement the Hill-Burton program.

What’s always impressed me about the guidelines is that it’s a consensus document. As members of FGI’s Health Guidelines Revisions Committee (HGRC), more than 125 volunteer healthcare and design professionals, researchers, and others allied to the field work on revisions during a four-year cycle.

And if you count all the others who participate in specialty task groups that also contribute to the process, the number of volunteers is probably more than 300. Not to mention the fact than anyone can submit a proposal or publically comment on the proposed revisions.

For the 2014 revisions cycle, the HGRC considered 1,995 proposals and 1,243 comments.

So what’s new besides the residential care volume? Too much to detail in this blog post, but according to Douglas Erickson, president of TME Inc. and FGI’s CEO, there’s new language on safety risk assessments and medication safety zones, revamped surgery and endoscopy requirements, increased requirements for commissioning infrastructure systems, and new requirements for technology systems. (Erickson was recently named to Healthcare Design’s 2013 class of The HCD 10 for his work at FGI. Read more here, The HCD 10: Douglas Erickson, Association/Foundation Executive.)

Significant changes have been made to improve the application of the guidelines to existing hospitals and outpatient facilities, too. This is a good thing, since big new buildings seem to be on the decline in favor of renovation and re-use.

Requirements for operating rooms and support areas in surgical facilities have also been revised.

Several important changes have been introduced to improve safety, too— the first of which is an owner-driven safety risk assessment (SRA). The idea is to foster a proactive approach to patient and caregiver safety by mitigating risks from the physical environment that could directly or indirectly contribute to harm.

The second change that impacts safety is the concept of the medication safety zone. A framework for a predesign medication safety risk assessment and minimum design requirements are now included to guide design and construction of medication safety zones across the continuum of care.

Erickson says that the biggest challenge in revising the guidelines is predicting the future of healthcare environments—because it takes four years to produce new guidelines and then three to four years for them to be adopted by federal and state agencies. The second biggest challenge is trying to figure out what is a minimum requirement versus a recommended practice.

And there’s no rest for the FGI volunteers; the 2018 revision cycle begins this year. I’ve heard from many who’ve worked on the guidelines that although it can be complicated and frustrating at times, it’s a very stimulating, satisfying project to be involved in. Important work, indeed.