Those involved in health care building projects know there are conflicts in the various standards and regulations. To compound this issue, authorities having jurisdiction (AHJs) solely focus on one set of documents instead of all of them. Given the number of AHJs that visit health care organizations, it is critical that a design is compliant with all applicable codes, standards and regulations all of the time. 

Due to the varying guidances available, during the schematic design phase, project teams should establish the applicable codes and standards the project will follow. Does the project follow the National Fire Protection Association’s (NFPA’s) Life Safety Code®, the International Code Council’s (ICC’s) International Building Code® or both? Best practice is to place this list on the cover page of the drawings so every project team member, operator or AHJ understands the guidance and intent.

When the codes and standards conflict, one method to overcome the issue is to adopt the most stringent approach. For example, NFPA standards currently state that wall projections such as handrails, sanitizer holders and isolation stations shall not protrude into the corridor more than 6 inches, whereas the Americans with Disabilities Act states they shall not protrude more than 4 inches. In this case, the ADA requirement is recommended, as it is more stringent.

The use of crosswalks is another way to ensure that design complies with all standards and regulations. The American Society for Health Care Engineering (ASHE) offers excellent crosswalks, including one that compares Centers for Medicare & Medicaid Services K-tags with Joint Commission standards, NFPA standards and ICC requirements. The ASHE document, Hospital Conditions of Participation/Accreditation Crosswalk, is available to ASHE members free.

ASHE is committed to aligning and moving toward unified codes, but it is not possible without support from members. It is the facilities professional’s responsibility to identify discrepancies, share data, provide input and share ideas. One of the easiest ways to get involved is to register and participate in the My ASHE online community.