The document provides an overview of the proposed changes to Michigan's healthcare code to adopt the 2018 FGI Guidelines for Design and Construction of Hospitals and Outpatient Facilities. It discusses the history and purpose of the FGI, differences between the 2007 Michigan code and 2018 FGI Guidelines, and some key environmental and architectural elements such as room use design requirements and handrail specifications. Adopting the 2018 FGI Guidelines will provide a more comprehensive set of standards across various healthcare facility types and disciplines.
Grand Round: RITHIM — A New Approach to Research in ManitobaCHICommunications
Research Improvements Through Harmonization in Manitoba (RITHIM) is the next step in streamlining and improving the research process. Together, we can improve the lives of Manitobans.
Pharmacy Services and Accountable Care Organizations Discussion.pdfsdfghj21
Pharmacy services can help accountable care organizations (ACOs) improve patient care and outcomes. A 1-page proposal should identify pharmacy services like chronic disease management, medication reconciliation after discharge, or annual wellness visits. These services help with benchmarks like readmissions, adherence to preventive screenings, and management of chronic conditions. Pharmacists can enhance care coordination, patient education, and medication optimization within ACOs.
ICD-10 Presentation to Bays Medical Society January 2014Florida Blue
Collaboration between physicians, payers and others across the health care industry is critical to a successful ICD10 implementation. Florida Blue is here with resources and expertise as you begin your ICD-10 journey, but the time to act is now! Visit our site to get started: http://ow.ly/sGVfF
Pchrd call for proposals for 2023 funding detailed final (3)ClydeBethBumatayCara
The document announces a call for research and development proposals for funding by the Philippine Council for Health Research and Development (PCHRD) in 2023. PCHRD will fund proposals that address priority health areas like mental health, disaster risk reduction, biomedical devices, and emerging diseases. Accepted proposals should contribute to better health outcomes in the Philippines. The document provides guidance on proposal requirements and outlines specific priority topics for biomedical devices including minimally invasive surgery devices, post-operative care devices, health emergency response devices, distributed healthcare devices, and simulation platforms for disease studies and medical training.
Pharmacy Services Development within ACO MSO Business Proposal.pdfsdfghj21
The document discusses implementing pharmacy services within an ACO/MSO business proposal. It provides background on ACOs, MSOs, and the evolving healthcare landscape. The proposal should include 1) pharmacy services to implement like medication therapy management, annual wellness visits, or chronic disease management and 2) how these services will improve patient care by impacting benchmarks for quality, care coordination, preventive health, and management of at-risk populations. The literature demonstrates benefits of these pharmacy services including reduced costs and improved outcomes.
The document discusses the S&I Framework Transitions of Care Initiative which aims to improve electronic exchange of core clinical information during care transitions. Over 150 members reached consensus on unambiguous definitions of core data elements for care transitions and agreed on using the Consolidated CDA standard for clinical summaries in Meaningful Use Stage 2. Pilots will test implementing the standard to enable cost-effective exchange of standardized care transition information. The initiative brings together various programs to specify a constrained CDA standard that meets their immediate goals for care transitions.
Advancing Medical Device Interoperability (MDI)Brandon Lock
Presentation to accompany the white paper, Advancing Medical Device Interoperability: Operationalizing the Integrated Clinical Environment and Building the Environment for Medical Device Interoperability.
Student: Brandon Lock
Class: HESY 670 - Introduction to Health Information Systems
Instructor: Dr. Hon Pak
Grand Round: RITHIM — A New Approach to Research in ManitobaCHICommunications
Research Improvements Through Harmonization in Manitoba (RITHIM) is the next step in streamlining and improving the research process. Together, we can improve the lives of Manitobans.
Pharmacy Services and Accountable Care Organizations Discussion.pdfsdfghj21
Pharmacy services can help accountable care organizations (ACOs) improve patient care and outcomes. A 1-page proposal should identify pharmacy services like chronic disease management, medication reconciliation after discharge, or annual wellness visits. These services help with benchmarks like readmissions, adherence to preventive screenings, and management of chronic conditions. Pharmacists can enhance care coordination, patient education, and medication optimization within ACOs.
ICD-10 Presentation to Bays Medical Society January 2014Florida Blue
Collaboration between physicians, payers and others across the health care industry is critical to a successful ICD10 implementation. Florida Blue is here with resources and expertise as you begin your ICD-10 journey, but the time to act is now! Visit our site to get started: http://ow.ly/sGVfF
Pchrd call for proposals for 2023 funding detailed final (3)ClydeBethBumatayCara
The document announces a call for research and development proposals for funding by the Philippine Council for Health Research and Development (PCHRD) in 2023. PCHRD will fund proposals that address priority health areas like mental health, disaster risk reduction, biomedical devices, and emerging diseases. Accepted proposals should contribute to better health outcomes in the Philippines. The document provides guidance on proposal requirements and outlines specific priority topics for biomedical devices including minimally invasive surgery devices, post-operative care devices, health emergency response devices, distributed healthcare devices, and simulation platforms for disease studies and medical training.
Pharmacy Services Development within ACO MSO Business Proposal.pdfsdfghj21
The document discusses implementing pharmacy services within an ACO/MSO business proposal. It provides background on ACOs, MSOs, and the evolving healthcare landscape. The proposal should include 1) pharmacy services to implement like medication therapy management, annual wellness visits, or chronic disease management and 2) how these services will improve patient care by impacting benchmarks for quality, care coordination, preventive health, and management of at-risk populations. The literature demonstrates benefits of these pharmacy services including reduced costs and improved outcomes.
The document discusses the S&I Framework Transitions of Care Initiative which aims to improve electronic exchange of core clinical information during care transitions. Over 150 members reached consensus on unambiguous definitions of core data elements for care transitions and agreed on using the Consolidated CDA standard for clinical summaries in Meaningful Use Stage 2. Pilots will test implementing the standard to enable cost-effective exchange of standardized care transition information. The initiative brings together various programs to specify a constrained CDA standard that meets their immediate goals for care transitions.
Advancing Medical Device Interoperability (MDI)Brandon Lock
Presentation to accompany the white paper, Advancing Medical Device Interoperability: Operationalizing the Integrated Clinical Environment and Building the Environment for Medical Device Interoperability.
Student: Brandon Lock
Class: HESY 670 - Introduction to Health Information Systems
Instructor: Dr. Hon Pak
Larry Wolf, Kindred’s Health Information Technology Strategist, addressed the importance of information technology as one component for improving care at the Alliance for Home Health Quality and Innovation Symposium.
1. The E/M Workgroup revised office visit codes for 2021 to simplify documentation and coding.
2. Code selection can now be based on either medical decision making (MDM) or total time spent on the encounter, including non-face-to-face services, rather than history and examination.
3. The revisions include time thresholds for each code and clarified MDM guidelines.
Supporting a Continuous Process Improvement Model With A Cost-Effective Data ...Juan Negrin, M.A., PMP
Presentation given at CHIME by Dave Hynson and Juan Negrin of steps followed at GBMC to develop and maintain a cost-effective data warehouse, in support of the organization's strategic needs. ACO reporting and process improvement examples are given.
This document provides an overview of a presentation given by representatives from the Pennsylvania eHealth Initiative (PAeHI) on approaches to achieving financial sustainability for health information exchanges (HIEs). It discusses PAeHI's role in coordinating HIE efforts across Pennsylvania. A case study examines the unique challenges and opportunities for HIEs in Pennsylvania based on factors like its large rural populations and many small hospitals. The case study also analyzes different HIE models including those integrated within large health systems, community/regional HIEs, and a statewide HIE. It proposes a framework for these different models to coexist and identifies next steps for HIE development in Pennsylvania.
Emerging Public Health Issues Health Equity (Page 3) Public Health Accreditat...CookCountyPLACEMATTERS
"This tip sheet is provided to accredited health departments to use as they prepare their annual reports." "Health equity is noted as an emerging public health issue because best and promising practices are moving the science and practice of public health beyond the traditional considerations of minority health and health disparities to more comprehensive concepts associated with ensuring deliberate consideration of the multiple determinants of health."
The document summarizes the proposed Medicare Shared Savings Program which aims to promote accountable care through accountable care organizations (ACOs). It discusses key elements of the proposed rule including ACO qualification requirements, benchmark calculations for determining savings, performance measures tied to quality, and a timeline for implementation beginning in 2012. The overall goal is to align payments with value through shared savings models to reduce costs while improving care quality.
The Value-Based Musculoskeletal Service LineWellbe
As healthcare reform continues to impact the provision and payment of care, hospitals and healthcare systems are challenged with redesigning the way musculoskeletal (MSK) services are delivered. Reimbursement and incentive structures are evolving toward value-based models and, in turn, organization must evaluate their MSK service lines to ensure that they are:
Integrated – MSK services must encompass the complete continuum of care and bother operative and nonoperative services need to be designed around preventive medicine, acute care, and post-acute care.
Scalable – Prevailing MSK service lines will be aligned with strategic partners to secure needed services and enhance market coverage, strategically and efficiently deploy capital for resources, cultivate population health competencies, and achieve economies of scale.
Rationalized – In addition to reducing costs and enhancing efficiencies, leadership of MSK services across a system of care increasingly must consider the consolidation or redistribution of key programs (e.g. Joint replacement) to optimize resources and ensure high-quality care is provided in the most accessible manner.
Informed – MSK service line leadership will be well informed about potentially drastic shifts in the payment environment at the local, regional, and national level. Further, they will effectively leverage operational and clinical data to inform the decision-making process.
Responsive – In addition to being informed, high-performing MSK programs will exhibit lean, vertical, and proactive leadership and decision-making structures that decisively drive the organization forward, particularly during times of change and uncertainty.
During this 60-minute webinar, John Fink and Todd Godfrey will share examples of how organizations are developing innovative MSK service line programs to keep pace with the shift toward a value-based environment.
This document discusses strategies for addressing challenges and opportunities in the post-ICD-10 deadline period. It outlines considerations in the short term of analyzing key metrics and identifying other important dates in the first few weeks and months. In the long term, it discusses how the increased specificity of ICD-10 can be used to support new technologies, payment models, and population health through better understanding of conditions and outcomes. The document was presented by the director of IT at BlueCross BlueShield of South Carolina and past chair of WEDI, the industry organization advising HHS on healthcare information exchange.
Deena ppt digital transformation of Healthcare RecordsDeenadayalan Sekar
The document discusses the digital transformation of medical records from physical to electronic formats. It outlines the objectives of CBHI and HERA-INDIA in maintaining health records and profiles. The challenges of adopting digital technologies in healthcare are presented, as well as the wide scope for transformation. The process of digitization is described, including file scanning, custom software development, and EMR implementation. Feedback collected showed improved doctor documentation and data analysis capabilities. Challenges remain around inappropriate EMR use and less patient interaction time. An integrated care model with centralized records is presented as a successful transformation process.
Presentation by Dr Aaron McKethan, who's running the Beacon Communities project at ONC. This was the presentation he gave to the Health 2.0 Community in the webinar on July 21
This webinar addresses a review of OIG Work Plan issues for hospitals, clinics and other health care providers with particular emphasis on coding, billing and reimbursement. FY2019 Work Plan issues are addressed in the context of OIG Work Plan issues from FY2014 through FY2018. Pertinent reports issued by the OIG are also discussed particularly in in relation to established OIG issues. Reports issued by the OIG relative to fraud and abuse relative to coding and billing are reviewed.
Additionally, associated RAC issues are discussed relative to current and anticipated trends. Particular attention is given to identification of issues in the context of internal and external auditing to make certain that any OIG and RAC issues are adequately addressed by health care providers. For this workshop, the main concentration of issues will involve hospitals and facilities. Physician concerns involving hospitals will also be addressed.
Just what are these OIG Work Plans?
What kind of reports are issued relative to these Work Plan issues?
Do hospitals and other healthcare providers need to be concerned?
Why do these work plans get longer and more involved each year?
Why is there such as emphasis on coding, billing and the false claims act?
Are there any trends in issuance of the work plans over the past several years?
What kinds of resources does the OIG have?
How do the OIG studies fit into the RACs and other federal auditing entities?
Does anyone pay any attention to these OIG reports and recommendations?
Does CMS always follow the recommendations of the OIG?
Over the years are there any emerging trends in the issues addressed by the OIG Work Plans?
Where can I access these work plans and the reports that are issued relative to the identified issues.
When is the OIG Work Plan supposed to be issued each year?
Does the OIG issue rule changed through the Federal Register?
PYA Presented on 2021 E/M Changes and a CARES Act Update During GHA Complianc...PYA, P.C.
The Georgia Hospital Association (GHA) Compliance Officers Roundtable, an active GHA group that meets quarterly and includes educational sessions featuring government representatives, industry experts, and other thought leaders speaking about compliance-related issues, conducted their latest meeting virtually. PYA Principals Lori Foley, Tynan Kugler, and Valerie Rock were among the presenters at this quarter’s event. In their session, they:
Described key elements associated with 2021 E/M changes, and strategies for preparation and implementation.
Explained the impact of 2021 E/M changes on physician compensation and contracting, including potential mitigation approaches.
Presented key components of Stark Law and Anti-Kickback Statute final rules.
Provided an update on the CARES Act.
The Compliance Certification Board offered CEUs for this event, which took place on Friday, December 4, 2020.
The PPS [Prospective Payment System] to PDPM Pendulum: An Analysis of PDPM Co...PYA, P.C.
The Skilled Nursing Facility (SNF) industry has faced disruption with Medicare Part A’s transition to the Patient Driven Payment Model (PDPM) in the fall of 2019. Providers seeking additional guidance to further develop and shape their compliance programs are encouraged to view the presentation given by join PYA at the AHLA Long Term Care and the Law program in March of 2020.
PYA Post-Acute Service Line Manager Amy Dalton co-presented with Liz Steffen, MJ CHC CPHRM MBA HCM MA CCC-SLP, Senior Divisional Corporate Compliance Officer of Promedica Health System. “The PPS [Prospective Payment System] to PDPM Pendulum: An Analysis of PDPM Compliance Matters Post Go-Live” covers the following topics:
• Trends in care provision related to value-based outcomes and quality of care.
• Relevant compliance updates from the Department of Health and Human Services, Department of Justice, and Office of Inspector General.
• Clinical operational and compliance-related hurdles for SNFs post-PDPM go-live.
• How PDPM fits into the larger context of a SNF compliance program.
• PDPM recommendations and best practices going forward.
Costing HIV testing services: understanding and using data for decision makingCarmen Figueroa
This document discusses costing methods for HIV testing services. It aims to present key questions to interrogate cost evidence and support commissioning cost studies. The learning outcomes are to understand why HIV testing costs vary, recognize different cost definitions and analysis methods, and define what type of analyses are needed to address policy questions. It discusses financial vs. economic costs, full vs. incremental costs, project phases, perspectives, and inflation. Real differences in resource use can be due to scale, distribution model, population characteristics, and prevalence. The appropriate costing method depends on the question being asked - economic evaluation focuses on should we do it? while budget impact analysis addresses can we afford it?
Health IT Summit Denver 2014 - "Anatomy of a Health System"
This unique discussion series explores behind-the-scenes looks at the most progressive and high performing health systems in the country. Panelists will discuss critical areas such as go-live strategy, vendor management, patient engagement, IT governance and more. Attendees will walk away with a better understanding of how departments can effectively work together, tangible strategies for delivering high quality care while maintaining an efficient and secure health information system.
Moderator: Cynthia Burghard, Research Director, IDC Health Insights
Marc Lassaux, CTO, Technical Director Beacon Project, Quality Health Network
Justin Aubert, Chief Financial Officer, Quality Health Network
Kevin Fitzgerald, MD, CMO, Rocky Mountain Health
Larry Wolf, Kindred’s Health Information Technology Strategist, addressed the importance of information technology as one component for improving care at the Alliance for Home Health Quality and Innovation Symposium.
1. The E/M Workgroup revised office visit codes for 2021 to simplify documentation and coding.
2. Code selection can now be based on either medical decision making (MDM) or total time spent on the encounter, including non-face-to-face services, rather than history and examination.
3. The revisions include time thresholds for each code and clarified MDM guidelines.
Supporting a Continuous Process Improvement Model With A Cost-Effective Data ...Juan Negrin, M.A., PMP
Presentation given at CHIME by Dave Hynson and Juan Negrin of steps followed at GBMC to develop and maintain a cost-effective data warehouse, in support of the organization's strategic needs. ACO reporting and process improvement examples are given.
This document provides an overview of a presentation given by representatives from the Pennsylvania eHealth Initiative (PAeHI) on approaches to achieving financial sustainability for health information exchanges (HIEs). It discusses PAeHI's role in coordinating HIE efforts across Pennsylvania. A case study examines the unique challenges and opportunities for HIEs in Pennsylvania based on factors like its large rural populations and many small hospitals. The case study also analyzes different HIE models including those integrated within large health systems, community/regional HIEs, and a statewide HIE. It proposes a framework for these different models to coexist and identifies next steps for HIE development in Pennsylvania.
Emerging Public Health Issues Health Equity (Page 3) Public Health Accreditat...CookCountyPLACEMATTERS
"This tip sheet is provided to accredited health departments to use as they prepare their annual reports." "Health equity is noted as an emerging public health issue because best and promising practices are moving the science and practice of public health beyond the traditional considerations of minority health and health disparities to more comprehensive concepts associated with ensuring deliberate consideration of the multiple determinants of health."
The document summarizes the proposed Medicare Shared Savings Program which aims to promote accountable care through accountable care organizations (ACOs). It discusses key elements of the proposed rule including ACO qualification requirements, benchmark calculations for determining savings, performance measures tied to quality, and a timeline for implementation beginning in 2012. The overall goal is to align payments with value through shared savings models to reduce costs while improving care quality.
The Value-Based Musculoskeletal Service LineWellbe
As healthcare reform continues to impact the provision and payment of care, hospitals and healthcare systems are challenged with redesigning the way musculoskeletal (MSK) services are delivered. Reimbursement and incentive structures are evolving toward value-based models and, in turn, organization must evaluate their MSK service lines to ensure that they are:
Integrated – MSK services must encompass the complete continuum of care and bother operative and nonoperative services need to be designed around preventive medicine, acute care, and post-acute care.
Scalable – Prevailing MSK service lines will be aligned with strategic partners to secure needed services and enhance market coverage, strategically and efficiently deploy capital for resources, cultivate population health competencies, and achieve economies of scale.
Rationalized – In addition to reducing costs and enhancing efficiencies, leadership of MSK services across a system of care increasingly must consider the consolidation or redistribution of key programs (e.g. Joint replacement) to optimize resources and ensure high-quality care is provided in the most accessible manner.
Informed – MSK service line leadership will be well informed about potentially drastic shifts in the payment environment at the local, regional, and national level. Further, they will effectively leverage operational and clinical data to inform the decision-making process.
Responsive – In addition to being informed, high-performing MSK programs will exhibit lean, vertical, and proactive leadership and decision-making structures that decisively drive the organization forward, particularly during times of change and uncertainty.
During this 60-minute webinar, John Fink and Todd Godfrey will share examples of how organizations are developing innovative MSK service line programs to keep pace with the shift toward a value-based environment.
This document discusses strategies for addressing challenges and opportunities in the post-ICD-10 deadline period. It outlines considerations in the short term of analyzing key metrics and identifying other important dates in the first few weeks and months. In the long term, it discusses how the increased specificity of ICD-10 can be used to support new technologies, payment models, and population health through better understanding of conditions and outcomes. The document was presented by the director of IT at BlueCross BlueShield of South Carolina and past chair of WEDI, the industry organization advising HHS on healthcare information exchange.
Deena ppt digital transformation of Healthcare RecordsDeenadayalan Sekar
The document discusses the digital transformation of medical records from physical to electronic formats. It outlines the objectives of CBHI and HERA-INDIA in maintaining health records and profiles. The challenges of adopting digital technologies in healthcare are presented, as well as the wide scope for transformation. The process of digitization is described, including file scanning, custom software development, and EMR implementation. Feedback collected showed improved doctor documentation and data analysis capabilities. Challenges remain around inappropriate EMR use and less patient interaction time. An integrated care model with centralized records is presented as a successful transformation process.
Presentation by Dr Aaron McKethan, who's running the Beacon Communities project at ONC. This was the presentation he gave to the Health 2.0 Community in the webinar on July 21
This webinar addresses a review of OIG Work Plan issues for hospitals, clinics and other health care providers with particular emphasis on coding, billing and reimbursement. FY2019 Work Plan issues are addressed in the context of OIG Work Plan issues from FY2014 through FY2018. Pertinent reports issued by the OIG are also discussed particularly in in relation to established OIG issues. Reports issued by the OIG relative to fraud and abuse relative to coding and billing are reviewed.
Additionally, associated RAC issues are discussed relative to current and anticipated trends. Particular attention is given to identification of issues in the context of internal and external auditing to make certain that any OIG and RAC issues are adequately addressed by health care providers. For this workshop, the main concentration of issues will involve hospitals and facilities. Physician concerns involving hospitals will also be addressed.
Just what are these OIG Work Plans?
What kind of reports are issued relative to these Work Plan issues?
Do hospitals and other healthcare providers need to be concerned?
Why do these work plans get longer and more involved each year?
Why is there such as emphasis on coding, billing and the false claims act?
Are there any trends in issuance of the work plans over the past several years?
What kinds of resources does the OIG have?
How do the OIG studies fit into the RACs and other federal auditing entities?
Does anyone pay any attention to these OIG reports and recommendations?
Does CMS always follow the recommendations of the OIG?
Over the years are there any emerging trends in the issues addressed by the OIG Work Plans?
Where can I access these work plans and the reports that are issued relative to the identified issues.
When is the OIG Work Plan supposed to be issued each year?
Does the OIG issue rule changed through the Federal Register?
PYA Presented on 2021 E/M Changes and a CARES Act Update During GHA Complianc...PYA, P.C.
The Georgia Hospital Association (GHA) Compliance Officers Roundtable, an active GHA group that meets quarterly and includes educational sessions featuring government representatives, industry experts, and other thought leaders speaking about compliance-related issues, conducted their latest meeting virtually. PYA Principals Lori Foley, Tynan Kugler, and Valerie Rock were among the presenters at this quarter’s event. In their session, they:
Described key elements associated with 2021 E/M changes, and strategies for preparation and implementation.
Explained the impact of 2021 E/M changes on physician compensation and contracting, including potential mitigation approaches.
Presented key components of Stark Law and Anti-Kickback Statute final rules.
Provided an update on the CARES Act.
The Compliance Certification Board offered CEUs for this event, which took place on Friday, December 4, 2020.
The PPS [Prospective Payment System] to PDPM Pendulum: An Analysis of PDPM Co...PYA, P.C.
The Skilled Nursing Facility (SNF) industry has faced disruption with Medicare Part A’s transition to the Patient Driven Payment Model (PDPM) in the fall of 2019. Providers seeking additional guidance to further develop and shape their compliance programs are encouraged to view the presentation given by join PYA at the AHLA Long Term Care and the Law program in March of 2020.
PYA Post-Acute Service Line Manager Amy Dalton co-presented with Liz Steffen, MJ CHC CPHRM MBA HCM MA CCC-SLP, Senior Divisional Corporate Compliance Officer of Promedica Health System. “The PPS [Prospective Payment System] to PDPM Pendulum: An Analysis of PDPM Compliance Matters Post Go-Live” covers the following topics:
• Trends in care provision related to value-based outcomes and quality of care.
• Relevant compliance updates from the Department of Health and Human Services, Department of Justice, and Office of Inspector General.
• Clinical operational and compliance-related hurdles for SNFs post-PDPM go-live.
• How PDPM fits into the larger context of a SNF compliance program.
• PDPM recommendations and best practices going forward.
Costing HIV testing services: understanding and using data for decision makingCarmen Figueroa
This document discusses costing methods for HIV testing services. It aims to present key questions to interrogate cost evidence and support commissioning cost studies. The learning outcomes are to understand why HIV testing costs vary, recognize different cost definitions and analysis methods, and define what type of analyses are needed to address policy questions. It discusses financial vs. economic costs, full vs. incremental costs, project phases, perspectives, and inflation. Real differences in resource use can be due to scale, distribution model, population characteristics, and prevalence. The appropriate costing method depends on the question being asked - economic evaluation focuses on should we do it? while budget impact analysis addresses can we afford it?
Health IT Summit Denver 2014 - "Anatomy of a Health System"
This unique discussion series explores behind-the-scenes looks at the most progressive and high performing health systems in the country. Panelists will discuss critical areas such as go-live strategy, vendor management, patient engagement, IT governance and more. Attendees will walk away with a better understanding of how departments can effectively work together, tangible strategies for delivering high quality care while maintaining an efficient and secure health information system.
Moderator: Cynthia Burghard, Research Director, IDC Health Insights
Marc Lassaux, CTO, Technical Director Beacon Project, Quality Health Network
Justin Aubert, Chief Financial Officer, Quality Health Network
Kevin Fitzgerald, MD, CMO, Rocky Mountain Health
Similar to fgi_presentation_mishe_ec_2019_12_13.pdf (20)
The document provides an instruction manual for the FluorCam instrument, which measures chlorophyll fluorescence to study photosynthesis. It begins with an introduction to chlorophyll fluorescence techniques, explaining how fluorescence yields provide information about photosynthetic energy conversion. It then describes the FluorCam instrument and various models. The manual explains how to assemble, operate, and analyze data from the FluorCam using its software. It provides protocols for capturing fluorescence transients and imaging fluorescence to study spatial heterogeneity and kinetics of photosynthesis.
Phenotyping for crop improvement requires integrated concepts and infrastructure to fully explore its potential. The EMPHASIS project aims to implement a pan-European research infrastructure for plant phenotyping to address challenges in crop development. It is currently in the implementation phase (2019-2021) to establish long-term operations, engage member countries, and set up services to ensure sustainable access. The infrastructure will integrate specialized facilities, environmental controls, and expertise in imaging, sensor techniques, and data analysis to allow quantitative assessment of plant phenotypes across scales from single plants to fields.
This document summarizes an experiment that used an automated plant phenotyping platform to analyze the drought tolerance of different barley genotypes. Two barley accessions (W30 and Abyssinian 1125) that showed contrasting responses to drought were selected. Plants were subjected to a drought period followed by rewatering to evaluate recovery. Throughout, various traits like plant area, chlorophyll fluorescence, and leaf temperature were measured. The results showed that W30 recovered well after rewatering, while Abyssinian 1125 did not recover significantly. This demonstrated different drought tolerance strategies between the two accessions.
The document describes using an automated high-throughput phenotyping platform called PlantScreenTM Conveyer System to visualize and quantify the early stress response of Arabidopsis thaliana plants to the herbicide glyphosate. RGB imaging, chlorophyll fluorescence kinetics imaging, and hyperspectral imaging were used to analyze plant structure, growth, and photosynthetic performance over 72 hours after glyphosate application. Results showed glyphosate impaired growth dynamics after 20 hours and decreased chlorophyll content and photosynthetic performance within 10-13 hours, as indicated by changes in fluorescence parameters, NDVI, and other indices. The study demonstrated how high-throughput phenotyping can help characterize plant stress responses and accelerate crop breeding.
This study used a high-throughput phenotyping platform called PlantScreen System to analyze early plant stress responses under progressive drought conditions. Various imaging techniques were used including RGB imaging, chlorophyll fluorescence imaging, and thermal imaging. Parameters like area, compactness, and maximum fluorescence in the light-adapted state were identified as early discriminants between stressed and control plants. Changes in chlorophyll fluorescence kinetics and decreases in maximum fluorescence occurred in stressed plants after 7-8 days, indicating their potential as early drought stress markers.
1) The study used high-throughput imaging technologies to analyze the early responses of Arabidopsis thaliana plants to salt stress, comparing accessions Col-0 and the more salt-tolerant C24.
2) Within days of salt treatment, plant growth was reduced, photosynthetic performance declined, and color changes occurred, indicating stress. C24 was less affected than Col-0.
3) Quantitative analysis of chlorophyll fluorescence kinetics and imaging data revealed rapid reductions in key photosynthetic parameters and increases in non-photochemical quenching in salt-treated plants, showing immediate physiological impacts of stress.
This document summarizes research using an automated PlantScreen system to study the response of Arabidopsis plants to salt stress. Various Arabidopsis ecotypes were grown under normal conditions then exposed to salt stress. Automated kinetic phenotyping was performed using chlorophyll fluorescence imaging and RGB imaging to analyze plant growth, development, and physiology. Chlorophyll fluorescence measurements identified early response stress markers, with statistically significant differences seen in some parameters like NPQ and Rfd between treated and untreated plants within 48 hours. RGB imaging also tracked morphological changes over time.
This document describes a study that used automated plant phenotyping systems to evaluate the effects of 9 different plant-derived biostimulants on tomato plants under control conditions. High-throughput image-based analysis was used to monitor multiple morphological and physiological traits over time. Preliminary results found that 3 biostimulants (A, E, and H) significantly increased plant growth compared to controls. Additional analysis of chlorophyll fluorescence data may provide insights into effects on photosynthetic efficiency and correlate with growth responses. The automated phenotyping platform allowed detailed non-invasive analysis of biostimulant modes of action on whole plant performance.
This document summarizes an experiment that used high-throughput phenotyping to analyze the growth and photosynthetic performance of two lettuce cultivars (Aquino and Barlach) under control and drought stress conditions over 36 days. Seedlings were grown in a controlled environment chamber and divided into control and stressed plants at 18 days after sowing. Automated imaging and measurements were taken every two days using a PlantScreen system. Both cultivars showed similar reductions in area and photosystem II efficiency under drought, though stress effects appeared earlier in Barlach. Overall, the analysis found the two cultivars responded similarly to drought but Barlach reached a larger size. The high-throughput phenotyping platform allowed precise monitoring
PlantScreen™ Modular Systems | QubitPhenomics.com.pdftachet
Qubit Systems develops modular plant phenotyping systems called PlantScreen for automated multidimensional analysis of plant growth and physiology. The PlantScreen Modular System uses a conveyor to move plants through different imaging stations for traits like color, chlorophyll fluorescence, hyperspectral analysis, and temperature. It also has controlled environment chambers and stations for watering, weighing, and nutrient delivery. Comprehensive software controls the system and stores/analyzes imaging and environmental data. Custom systems can be designed to fit specific research needs.
6th International Conference on Machine Learning & Applications (CMLA 2024)ClaraZara1
6th International Conference on Machine Learning & Applications (CMLA 2024) will provide an excellent international forum for sharing knowledge and results in theory, methodology and applications of on Machine Learning & Applications.
Literature Review Basics and Understanding Reference Management.pptxDr Ramhari Poudyal
Three-day training on academic research focuses on analytical tools at United Technical College, supported by the University Grant Commission, Nepal. 24-26 May 2024
Advanced control scheme of doubly fed induction generator for wind turbine us...IJECEIAES
This paper describes a speed control device for generating electrical energy on an electricity network based on the doubly fed induction generator (DFIG) used for wind power conversion systems. At first, a double-fed induction generator model was constructed. A control law is formulated to govern the flow of energy between the stator of a DFIG and the energy network using three types of controllers: proportional integral (PI), sliding mode controller (SMC) and second order sliding mode controller (SOSMC). Their different results in terms of power reference tracking, reaction to unexpected speed fluctuations, sensitivity to perturbations, and resilience against machine parameter alterations are compared. MATLAB/Simulink was used to conduct the simulations for the preceding study. Multiple simulations have shown very satisfying results, and the investigations demonstrate the efficacy and power-enhancing capabilities of the suggested control system.
A SYSTEMATIC RISK ASSESSMENT APPROACH FOR SECURING THE SMART IRRIGATION SYSTEMSIJNSA Journal
The smart irrigation system represents an innovative approach to optimize water usage in agricultural and landscaping practices. The integration of cutting-edge technologies, including sensors, actuators, and data analysis, empowers this system to provide accurate monitoring and control of irrigation processes by leveraging real-time environmental conditions. The main objective of a smart irrigation system is to optimize water efficiency, minimize expenses, and foster the adoption of sustainable water management methods. This paper conducts a systematic risk assessment by exploring the key components/assets and their functionalities in the smart irrigation system. The crucial role of sensors in gathering data on soil moisture, weather patterns, and plant well-being is emphasized in this system. These sensors enable intelligent decision-making in irrigation scheduling and water distribution, leading to enhanced water efficiency and sustainable water management practices. Actuators enable automated control of irrigation devices, ensuring precise and targeted water delivery to plants. Additionally, the paper addresses the potential threat and vulnerabilities associated with smart irrigation systems. It discusses limitations of the system, such as power constraints and computational capabilities, and calculates the potential security risks. The paper suggests possible risk treatment methods for effective secure system operation. In conclusion, the paper emphasizes the significant benefits of implementing smart irrigation systems, including improved water conservation, increased crop yield, and reduced environmental impact. Additionally, based on the security analysis conducted, the paper recommends the implementation of countermeasures and security approaches to address vulnerabilities and ensure the integrity and reliability of the system. By incorporating these measures, smart irrigation technology can revolutionize water management practices in agriculture, promoting sustainability, resource efficiency, and safeguarding against potential security threats.
Introduction- e - waste – definition - sources of e-waste– hazardous substances in e-waste - effects of e-waste on environment and human health- need for e-waste management– e-waste handling rules - waste minimization techniques for managing e-waste – recycling of e-waste - disposal treatment methods of e- waste – mechanism of extraction of precious metal from leaching solution-global Scenario of E-waste – E-waste in India- case studies.
KuberTENes Birthday Bash Guadalajara - K8sGPT first impressionsVictor Morales
K8sGPT is a tool that analyzes and diagnoses Kubernetes clusters. This presentation was used to share the requirements and dependencies to deploy K8sGPT in a local environment.
We have compiled the most important slides from each speaker's presentation. This year’s compilation, available for free, captures the key insights and contributions shared during the DfMAy 2024 conference.
ML Based Model for NIDS MSc Updated Presentation.v2.pptx
fgi_presentation_mishe_ec_2019_12_13.pdf
1. 12.13.2019
FGI Guidelines for Design &
Construction of Hospitals-
2018…..An overview of
Michigan’s latest Healthcare
Code
• Osborn Engineering
• Dave Chouinard, CBCP, LEED AP, Director | Healthcare
• Jeff Bodway, PE, PMP, LEED AP BD+C, Associate Director | Energy and Facility Systems
2. 12.13.2019
Agenda/Objectives
1. Understand proposed administrative rules to update the Michigan Healthcare Design
Standard
2. An overview of the organization of FGI 2018
3. Learn about some differences from the 2007 Minimum Design Standard for Healthcare
Facilities in Michigan and FGI 2018
3. 12.13.2019
Facilities Guidelines Institute
• What is the FGI?
• An independent not-for-profit organization dedicated in developing guidance for planning,
designing, and construction of hospitals, outpatient facilities and residential healthcare and
support facilities.
• FGI partners with numerous other organizations (HHS/CMS, ASHE, NIH, AIA) to help develop
the Guidelines and other practical, evidence-informed publications.
• They oversee the FGI Guidelines for Design and Construction revision process and publication,
fund research, and offer resources that support the development of safe, effective health and
residential care built environments.
4. 12.13.2019
History
• Feburary 14, 1947 General Standards; Federal Register: Hill-Burton program
• 1974- Retitled: Minimum Requirements for Construction and Equipment for Hospital and
Medical Facilities
• 1984- Dept of Health and Human Services removed from Regulation and Requirements.
Federal government no longer retain guidelines in regulatory form.
• 1984- Now non-regulated, changed title to: Guidelines for Construction and Equipment of
Hospital and Medical Facilities. This document still used by many AHJ’s for
licensure/registration.
• 1983-84, HHS asked the AIA/CAH to form an advisory group, funded by the Public Health
Service for the next revision. Federal gov’t declined to publish the revised document. AIA/CAH
reach agreement with the AIA to publish the 1987 Ed.
• 1992-93 Ed. of the Guidelines published and distributed by the AIA and the name changed to:
“Guidelines for Design and Construction of Hospital and Health Care Facilities.”
5. 12.13.2019
History
• To create a more formal process to keep the document current, the Facility Guidelines Institute was
founded and in 2001, the first revision cycle was completed under the direction of the FGI.
• FGI received major funding from: HHS, ASHE, NIH and the AIA provided staff and technical support.
• 2006 ed. Received major funding form HHS/Centers for Medicare and Medicaid, ASHE, NIH and
the AIA.
• 2010 ed. Major funding from HHS/CMS and now ASHE provided the staff and technical support.
One major change to the 2010 edition…the addition of the 2008 ANSI/ASHRAE/ASHE Standard
170: Ventilation of Health Care Facilities.
• Standard 170 has what ASHRAE terms “continuous maintenance” project status in keeping
170 current with practice in the field. Meet periodically to develop proposed changed rather
than waiting for the end of the three-year Guidelines cycle. Official addenda are issued, e.g.
Addendum D lowering minimum relative humidity in OR’s from 30% to 20%, to represent state-
of-the-art thinking in the industry.
• 2014- Continue efforts to increase clarity and consistency in content. 2014 Guidelines for Design
and Constriction of Hospitals and Outpatient Facilities. The 2014 Guideline is used by CMS
presently.
6. 12.13.2019
2018
• 2018- In continuing effort to add clarity and better serve the Healthcare industry, FGI
published, for the first time, (3) separate targeted Guidelines:
7. 12.13.2019
What’s changed since 2007?
iPhone 1-Introduced January 2007
• $499 for 4GB
• 3.5-inch screen
• 2G Data
• 2.0MP Camera
• No GPS
iPhone 11-Introduced September 2019
• $699 for 64GB
• 6.06-inch LED IPS LCD
• Dual-lens 12MP Camera array
• Six Colors
8. 12.13.2019
Michigan Healthcare Code Background
Michigan Healthcare Code: (Issued in 2007) Code was formally adopted October 2015:
Minimum Design Standards for Healthcare Facilities in Michigan
• Enforced for 10+ years.
• Decision made to adopt FGI Guideline 2018 on June 2019 and is projected to go into effect
Q1 2020.
• Reason to adopt FGI 2018: FGI is more comprehensive and developed and it provides better
direction in all Disciplines.
• Environment of Care (EOC) / Architectural
• Fire Protection
• Technology
• HVAC
• Electrical
• Plumbing / Medical Gases
• Proposed Rules: https://dmbinternet.state.mi.us/DMB/ORRDocs/ORR/1778_2017-
101LR_orr-draft.pdf
9. 12.13.2019
Michigan Healthcare Design Standards-Changing Times
2007 Minimum Design Standards for
Healthcare Facilities in Michigan
Facilities Guidelines Institute (FGI)
Hospitals, Residential Health Care, and
Outpatient Facilities, 2018 Edition
10. 12.13.2019
Michigan - Rule 263
• “In performing a construction permit review for a health facility, the
department shall apply the following guidelines….”
• Facilities Guidelines Institute (FGI):
• Hospitals, Residential Health Care, and Outpatient Facilities, 2018
Edition
• ASHRAE 170-2017, Ventilation of Health Care Facilities
11. 12.13.2019
Michigan - Rule 265
• Describes when plans shall be submitted to HFES for review:
• New Buildings
• Additions
• Building Change
• Added definition: “means alterations to an existing building involving a
change in the interior configuration or intended use, including alterations
to the mechanical, electrical, or plumbing systems. This term does not
include routine maintenance or replacement with comparable
mechanical, electrical or plumbing equipment that does not alter the
current physical structure.”
• Conversion of existing structures for use as a health facility
12. 12.13.2019
2018 FGI Guidelines
• Hospital Guidelines
• Provides minimum design standards for:
• General Hospitals
• Freestanding Emergency Facilities
• Critical Access Hospitals
• Psychiatric Hospitals
• Rehabilitation Hospitals
• Children’s Hospitals
• Mobile/Transportable medical Units
• Elements of the FGI Guidelines for Hospitals
• Part 1: General
• Part 2: Hospital Facility Types
• Part 3: Ventilation of Health Care
Facilities (ASHRAE Standard 170-2017)
13. 12.13.2019
2018 FGI Guidelines
• Outpatient Facilities Guidelines
• Provides minimum design standards for
outpatient facility types
• General & Specialty Medical Services
Facilities
• Outpatient Imaging Facilities
• Birth Centers
• Urgent Care Facilities
• Infusion Centers
• Outpatient Surgery Facilities
• Freestanding Emergency Facilities
• Renal Dialysis Centers
• Outpatient Rehabilitation Facilities
• Endoscopy Facilities,
mobile/transportable medical units, and
dental units.
• Residential Healthcare & Support Facilities
Guidelines
• Provides minimum design standards for:
• Nursing Homes
• Hospice Facilities
• Assisted Living Facilities
• Substance Abuse Treatment Facilities,
• Settings for Individuals with intellectual
and/or developmental disabilities
• Independent Living Settings
• Adult Day Care Facilities
• Wellness Centers
• Outpatient Rehabilitation Facilities
• Homes for the Aged
14. 12.13.2019
Elements of the FGI Guidelines
• Part 1: General
1.1 Introduction (Minimum Standards,
earthquake, other regulations)
1.2 Planning, Design and Construction
• Functional Program
• Safety Risk Assessment
• Planning and Design Considerations
(Acoustic Design, Sustainable Design,
etc.)
• Commissioning
1.3 Site (Lighting, Signage, Parking,
Landscaping, etc.)
1.4 Equipment
• 1.2-4 Safety Risk Assessment
• Infection Control Risk Assessment
• Patient Handling & Movement
Assessment
• Fall Prevention Assessment
• Medication Safety Assessment
• Behavioral and Mental Health Risk
Assessment
• Patient Immobility Assessment
• Security Risk Assessment
15. 12.13.2019
Elements of the FGI Guidelines
• Part 2: Hospital Facility Types
2.1 Common Elements for Hospitals
2.2 Specific Elements for General
Hospitals
2.3 Specific Requirements for
Freestanding Emergency Care Facilities
2.4 Specific Requirements for Critical
Access Hospitals
2.5 Specific Requirements for Psychiatric
Hospitals
2.6 Specific Requirements for
Rehabilitation Hospitals
2.7 Specific Requirements for Children’s
Hospitals.
2.8 Specific Requirements for
Mobile/Transportable Medical Units
• 2.1 Common Elements for Hospitals
2.1-1 General
2.1-2 Patient Care Units
2.1-3 Diagnostic and Treatment Areas
(Exam/Treatment, Telemedicine)
2.1-4 Patient Support Facilities (Lab,
Pharmacy, Food Services)
2.1-5 General Support Facilities (SPD,
EVS, Linen, Engineering, etc.)
2.1-6 Public and Administrative Areas
2.1-7 Design and Construction
Requirements
2.1-8 Building Systems (HVAC, Plumbing,
Electrical, Communications, Security)
18. 12.13.2019
Room Use
Design Requirements2
Room Type Location Surfaces
Exam or
treatment
room
Patient care that may
require high-level
disinfected or sterile
instruments but does
not require the
environmental controls
of a procedure room
Unrestricted
area
Accessed from an
unrestricted area
Flooring: cleanable and wear-resistant for the
location; stable, firm, and slip-resistant
Wall finishes: washable
Ceiling: cleanable with routine housekeeping
equipment; lay-in ceiling permitted
Table 2.2-1: Examination Rooms
19. 12.13.2019
Room Use
Design Requirements2
Room Type Location Surfaces
Procedure
room
Patient care that requires
high-level disinfection of
the room, sterile
instruments, and some
environmental controls but
does not require the
environmental controls of
an operating room
Endoscopic procedures
Semi-restricted
area
Accessed from an
unrestricted or a semi-
restricted area
Flooring: cleanable and wear-resistant for the location;
stable, firm, and slip-resistant
Floor and wall base assemblies in cystoscopy, urology, and
endoscopy procedure rooms and endoscope processing
room: monolithic floor with integral coved wall base
carried up the wall a minimum of 6 inches
Wall finishes: washable
Wall finishes in endoscopy procedure room and
endoscope processing room: washable; free of fissures,
open joints, or crevices
Ceiling: smooth and without crevices, scrubbable, non-
absorptive, non-perforated; capable of withstanding
cleaning chemicals; lay-in ceiling permitted if gasketed or
each ceiling tile weighs at least one pound per square
foot and no perforated, tegular, serrated, or highly
textured tiles
Table 2.2-1: Procedure Rooms
20. 12.13.2019
Room Use
Design Requirements2
Room Type Location Surfaces
Operating
room
Invasive procedures
3
Any procedure during
which the patient will
require physiological
monitoring and is
anticipated to require
active life support
Restricted
area
Accessed from a
semi-restricted
area
Flooring: cleanable and wear-resistant for the
location; stable, firm, and slip-resistant
Floor and wall base assemblies: monolithic floor
with integral coved wall base carried up the wall a
minimum of 6 inches
Wall finishes: washable; free of fissures, open
joints, or crevices
Ceiling: monolithic, scrubbable, capable of
withstanding cleaning and/or disinfecting
chemicals, gasketed access openings
Table 2.2-1: Operating Rooms
21. 12.13.2019
Room Use
Design Requirements2
Room Type Location Surfaces
Class 1 imaging
room
Diagnostic radiography, fluoroscopy,
mammography, computed
tomography (CT), ultrasound,
magnetic resonance imaging (MRI),
and other imaging modalities
Services that use natural orifice entry
and do not pierce or penetrate natural
protective membranes
Unrestricted area Accessed from an
unrestricted area
Flooring: cleanable and wear-resistant for the location; stable, firm, and slip-
resistant
Wall finishes: washable
Ceiling: cleanable with routine housekeeping equipment; lay-in ceiling permitted
Class 2 imaging
room
Diagnostic and therapeutic
procedures such as coronary,
neurological, or peripheral
angiography
Electrophysiology procedures
Semi-restricted area Accessed from an unrestricted or
a semi-restricted area
Flooring: cleanable and wear-resistant for the location; stable, firm, and slip-
resistant
Floor and wall base assemblies: monolithic floor with integral coved wall base
carried up the wall a minimum of 6 inches
Wall finishes: washable; free of fissures, open joints, or crevices
Ceiling: smooth and without crevices, scrubbable, non-absorptive, non-
perforated; capable of withstanding cleaning chemicals; lay-in ceiling permitted
if gasketed or each ceiling tile weighs at least one pound per square foot and no
perforated, tegular, serrated, or highly textured tiles
Class 3 imaging
room
Invasive procedures
3
Any Class 2 procedure during which
the patient will require physiological
monitoring and is anticipated to
require active life support
Restricted area Accessed from a semi-restricted
area
Flooring: cleanable and wear-resistant for the location; stable, firm, and slip-
resistant
Floor and wall base assemblies: monolithic floor with integral coved wall base
carried up the wall a minimum of 6 inches
Wall finishes: washable; free of fissures, open joints, or crevices
Ceiling: monolithic, scrubbable, capable of withstanding cleaning and/or
disinfecting chemicals, gasketed access openings
Table 2.2-2: Imaging Services
22. 12.13.2019
Patients of Size
The term “Patients of Size” is used for
patients who require increased space for
care and mobilization.
“Bariatric Patient” refers to patients
specifically in for Bariatric surgery.
23. 12.13.2019
Accommodations for Patients of Size
• Patient Room Clearance Requirements
• 5’-0” Clearance at foot of patient bed
• 5’-6” on non-transfer side of the bed
• On Transfer side of the bed
• Ceiling/Wall Lift: Rectangle 10’-6” by 5’-6”, located 2’ from the headwall
• Mobile Lift: Rectangle 10’-6” by 7’-0”, located 2’ from the headwall
• Door Opening: Minimum 57” clear width
• Patient Toilet Room
• Expanded capacity toilet located a minimum of 36” from finished wall to centerline (each
side)
• Regular toilet located a minimum of 44” from finished wall to centerline (each side)
• 46” Wide clear area in front of toilet 72” deep
• Shower Stall: Minimum of 4’-0” by 6’-0”
• Door Opening: Minimum 45.5” clear width
24. 12.13.2019
Airborne Infectious Isolation (AII) Rooms-Arch
• Permitted to have either self-closing door or audible alarm that can be activated when the
room used as an isolation room.
• PPE storage at the entrance to the room.
• Doors will have edge seals along sides & top of the door frame, bottom edge door sweep is
permitted to assist in maintaining negative pressure.
• Ante-room is not required, but is allowed and shall meet the following:
• Space for putting on PPE prior to entering patient room.
• All doors have either self-closing device or audible alarm.
• Hand-Washing Station
• Storage and disposal for PPE
26. 12.13.2019
Airborne Infection Isolation, Protective
Environment and Combo AII/PE Rooms
Mi2007 HC
• AII – Discussed in several sections and
design parameters outlined.
• PE – HEPA filters and directed airflow (clean
to less clean) required.
• Combo AII/PE – mentioned only as a facility
specific requirement and when present an
Ante Room must be provided.
• Automated continuous monitoring –
mentioned as being a requirement only
when required by AIA Guidelines
FGI 2018
• AII – specific requirements defined, Ante
Rooms recommended but optional
• PE – specific requirements defined, Ante
Rooms recommended but optional
• Combo AII/PE Rooms available to customize
pressure relationships to specific
medical/infection control needs. Ante Room
Required.
• Detailed pressures and relationships clearly
defined.
• Continuous pressure monitoring required.
27. 12.13.2019
Ventilation Requirements
Mi2007 HC FGI 2018
The comparable FGI tables for ventilation have been expanded to include specific tables for Hospitals,
Outpatient Spaces and other facility types. FGI Tables also combine the information for acceptable humidity
and temperature ranges with the ventilation tables. Mi2007 provided this information in separate tables.
28. 12.13.2019
Table 7.1 Design Parameters-Hospital Spaces
Function of Space
Pressure
Relationship
to Adjacent
Areas (n)
Minimum
Outdoor ach
Minimum Total
ach
All Room Air Exhausted
Directly
to Outdoors (j)
Air Recirculated by
Means of Room Units
(a)
Design
Relative
Humidity (k),
%
Design Temperature (l),
°F/°C
SURGERY AND CRITICAL CARE
Critical and intensive care NR 2 6 NR No 30–60 70–75/21–24
Delivery room (Caesarean) (m), (o) Positive 4 20 NR No 20–60 68–75/20–24
Emergency department
decontamination
Negative 2 12 Yes No NR NR
Emergency department
exam/treatment room (p)
NR 2 6 NR NR Max 60 70–75/21–24
Emergency department public
waiting area
Negative 2 12 Yes (q) NR Max 65 70–75/21–24
Intermediate care (s) NR 2 6 NR NR Max 60 70–75/21–24
Laser eye room Positive 3 15 NR No 20–60 70–75/21–24
Medical/anesthesia gas storage (r) Negative NR 8 Yes NR NR NR
Newborn intensive care Positive 2 6 NR No 30–60 72–78/22–26
Operating room (m), (o) Positive 4 20 NR No 20–60 68–75/20–24
Operating/surgical cystoscopic
rooms (m), (o)
Positive 4 20 NR No 20–60 68–75/20–24
Procedure room (o), (d) Positive 3 15 NR No 20–60 70–75/21–24
Radiology waiting rooms Negative 2 12 Yes (q), (w) NR Max 60 70–75/21–24
Recovery room NR 2 6 NR No 20–60 70–75/21–24
Substerile service area NR 2 6 NR No NR NR
Trauma room (crisis or shock) (c) Positive 3 15 NR No 20–60 70–75/21–24
Treatment room (p) NR 2 6 NR NR 20–60 70–75/21–24
Triage Negative 2 12 Yes (q) NR Max 60 70–75/21–24
Wound intensive care (burn unit) NR 2 6 NR No 40–60 70–75/21–24
29. 12.13.2019
Table 7.1 Design Parameters-Hospital Spaces
Function of Space
Pressure
Relationship
to Adjacent
Areas (n)
Minimum
Outdoor ach
Minimum Total
ach
All Room Air Exhausted
Directly
to Outdoors (j)
Air Recirculated by
Means of Room Units
(a)
Design
Relative
Humidity (k),
%
Design Temperature (l),
°F/°C
INPATIENT NURSING
AII anteroom (u) (e) NR 10 Yes No NR NR
AII room (u) Negative 2 12 Yes No Max 60 70–75/21–24
Combination AII/PE anteroom (e) NR 10 Yes No NR NR
Combination AII/PE room Positive 2 12 Yes No Max 60 70-75/21-24
Continued care nursery N/R 2 6 N/R No 30–60 72–78/22–26
Labor/delivery/recovery (LDR)
(s)
NR 2 6 NR NR Max 60 70–75/21–24
Labor/delivery/recovery/postpa
rtum (LDRP) (s)
NR 2 6 NR NR Max 60 70–75/21–24
Newborn nursery suite NR 2 6 NR No 30–60 72–78/22–26
Nourishment area or room NR NR 2 NR NR NR NR
Patient corridor NR NR 2 NR NR NR NR
Patient room NR 2 4 (y) NR NR Max 60 70–75/21–24
PE anteroom (t) (e) NR 10 NR No NR NR
Protective environment room
(t)
Positive 2 12 NR No Max 60 70–75/21–24
Toilet room Negative NR 10 Yes No NR NR
30. 12.13.2019
Table 7.1 Design Parameters-Hospital Spaces
Function of Space
Pressure
Relationship
to Adjacent
Areas (n)
Minimum
Outdoor ach
Minimum Total
ach
All Room Air Exhausted
Directly
to Outdoors (j)
Air Recirculated by
Means of Room Units
(a)
Design
Relative
Humidity (k),
%
Design Temperature (l),
°F/°C
DIAGNOSTIC AND TREATMENT
Autopsy room Negative 2 12 Yes No NR 68–75/20–24
Bronchoscopy, sputum
collection,
and pentamidine
administration
Negative 2 12 Yes No NR 68–73/20–23
Dialysis treatment area NR 2 6 NR NR NR 72–78/22–26
Dialyzer reprocessing room Negative NR 10 Yes No NR NR
ECT procedure room NR 2 4 NR NR Max 60 72–78/22–26
Endoscope cleaning Negative 2 10 Yes No NR NR
Gastrointestinal endoscopy
procedure room (x)
NR 2 6 NR No 20–60 68–73/20–23
General examination room NR 2 4 NR NR Max 60 70–75/21–24
Nuclear medicine treatment
room
Negative 2 6 Yes NR NR 70–75/21–24
STERILE PROCESSING DEPARTMENTz
Clean workroom Positive 2 4 NR No Max 60 68–73/20–23
Decontamination room Negative 2 6 Yes No NR 60–73/16–23
Sterile storage room Positive 2 4 NR NR Max 60 Max 75/24
31. 12.13.2019
HVAC Filtration Efficiency
Mi2007 HC FGI 2018
The filtration requirements are similar in FGI to the current Michigan requirements, 2018 FGI provides much more
detail for more specific spaces and adds greater requirements such as the MERV 13 requirement for Hospice facilities.
32. 12.13.2019
Humidification
Mi2007 HC
• Recommends “clean-steam” injection via
steam-to-steam generators for
humidification steam.
• Direct steam injection is permitted provided
only FDA approved additives used to treat
boiler feed-water.
• Humidification feed-water may be supplied
either from soft or RO water.
FGI 2018
• Humidification can be provided via steam or
adiabatic high-pressure water-atomizing
humidifiers.
• All chemical additives used in steam
systems serving humidifiers shall comply
with FDA requirements.
• When Adiabatic Atomizing Humidifiers are
utilized the water shall be treated with RO
process, a UV-C sterilization light source and
a sub-micron filter.
34. 12.13.2019
Essential Electrical System
• FGI 2018 References:
• NFPA 70 National Electrical Code
• NFPA 99 Health Care Facilities Code
• NFPA 101 Life Safety Code
• NFPA 110 Standard for Emergency and
Standby Power Systems
• NFPA 111 Standard on Stored Electrical
Energy Emergency and Standby Power
Systems
• Acoustical Considerations for Generators
• Rule 301: Emergency Electrical Service
• Must be permanently installed.
• Capable of providing a minimum of 72
hours of service, more it the Emergency
Preparedness Plan (EP) requires it.
• Freestanding surgical outpatient facility
MAY reduce 72 hour requirement in
accordance with its EP to evacuate the
building.
35. 12.13.2019
Table 2.1-1: Electrical Receptacles for Patient Care Areas
Section Location Number of Single
Receptacles
1
Receptacle Locations
PATIENT BED LOCATIONS
2.1-2.4.2 AII room
2
12
2 at each side of the head of the bed
2 on all other walls
1 for a television, if used
1 for each motorized bed
2.2-2.2.2 Medical/surgical unit patient room
2
2.2-2.2.4.4 Protective environment room
2
2.2-2.5.2 Intermediate care unit patient room
2.2-2.9.2.2 Postpartum unit patient room
2
2.2-2.11.2 Pediatric and adolescent unit patient room
2
2.6-2.2.2 Rehabilitation unit patient room
2.2-2.6.2 Critical care unit (CCU) patient room
16
Convenient
3
to head of bed with one on each wall
2.2-2.7.2 Pediatric critical care unit patient room
2.2-2.8.2 Neonatal intensive care unit (NICU) patient care
station
2.2-2.9.3 LDR/LDRP room
16
8 convenient
3
to head of mother’s bed
4 convenient
3
to each bassinet with one on each wall
2.2-2.10.3.1 Newborn nursery patient care station 4 Convenient
3
to each bassinet
2.2-2.10.3.2 Continuing care nursery patient care station
5
Convenient
3
to head of each bed, crib, or bassinet (At least
50% of these outlets shall be connected to emergency
system power and be so labeled.)
2.5-2.2.2 Psychiatric nursing unit No minimum
36. 12.13.2019
Table 2.1-1: Electrical Receptacles for Patient Care Areas
Section Location Number of Single
Receptacles
1
Receptacle Locations
DIAGNOSTIC AND TREATMENT AREAS
2.1-3.2
Table 2.2-2
Examination room
Class 1 imaging room
8
4 convenient
3
to head of gurney or bed or on each lateral
side of the imaging gantry
2.2-2.9.11 Cesarean delivery room
30
4
16 convenient
3
to table placement
2 on each wall
6 in the infant care area
2.2-3.1.2.6 Treatment room for basic emergency services 12 Convenient
3
to head of gurney or bed
2.2-3.1.3.3 Triage room or area in the emergency department
6
Convenient
3
to head of gurney or bed (At least 50% of these
outlets shall be connected to emergency system power and be so
labeled.)
2.2-3.1.3.6 (2)
and (3)
Emergency department treatment room
12
Convenient
3
to head of gurney or bed
2.2-3.1.3.6 (4) Trauma/resuscitation emergency room 16 Convenient
3
to head of gurney or bed
2.2-3.2.2 Observation unit patient care station 8 4 convenient
3
to head of gurney or bed
2.2-3.3.2
Table 2.2-2
Procedure room (including endoscopy)
Class 2 imaging room
12
4 8 convenient
3
to table placement with at least one on each
wall
2.2-3.3.3
Table 2.2-2
Operating room
Class 3 imaging room
36
4 16 convenient
3
to table placement
2 on each wall
2.2-3.10.2 Hemodialysis patient care stations
8
4 on each side of a patient bed or lounge chair. (Two on each
side of the bed shall be connected to emergency power.)
POST-ANESTHESIA CARE LOCATIONS
2.1-3.4.4 Phase I post-anesthetic care (PACU) patient care
station
8
Convenient
3
to head of gurney or bed
2.1-3.4.5 Phase II recovery patient care station 4 Convenient
3
to gurney, lounge chair, or bed
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Nurse Call system
NO CHANGE!
Rule 321-includes Table 2:
Location of Nurse Call Devices
(same Table from 2007
Minimum Design Standards)
Per FGI, system must meet
requirements of UL 1069:
Standard for Hospital Signaling
and Nurse Call Equipment.
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Telecommunications Systems
FGI 2.1-8.5.2
Telecommunications Service Entrance Room (TSER)
At least one dedicate room for telecommunications functions
Restricted access
HVAC system must be on emergency power
Telecommunications Equipment Center (TEC)
Restricted access
All computer & networking equipment in TEC shall be served by UPS power
Electrical circuits serving TEC shall be dedicated to serving TEC.
HVAC system must be on emergency power
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Telecommunications Systems
FGI 2.1-8.5.2
Technology Distribution Room (TDR)
At least one per floor
Additional rooms as required to meet 292 foot maximum cabling distance for Ethernet cables
Minimum 3’ clearance on all sides of the equipment rack(s)
(2014 FGI previously had a minimum room size of 12’ x 16’ interior dimension)
Electrical circuits serving TDR will be dedicated to TDR
Cooling for rooms shall be on emergency power
Emergency Communication System
Emergency radio communication system shall be provided in each facility.
System shall operate independently of the buildings service and emergency power systems.
System shall have frequency capabilities to communicate with state emergency networks.
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Security System
Rule 323: A security system must be
provided that meets all of the following
objectives:
• Meet the needs of the population served
and services provided.
• Provide safe ingress and egress to the
health facility
• Restrict access to specific areas
including, but not limited to, all of the
following:
• Surgical Suites
• Central Sterile Supply
• Obstetric Unit
• Pediatric Unit
• Medication Storage Areas
2.1-8.6.2 Electronic Surveillance systems
• Not required, but if provided for the safety
of patients, devices installed in tamper
resistant enclosure
• Emergency power required for systems
43. 12.13.2019
Medical Gas Outlets
Mi2007 HC FGI 2018
FGI has more detailed space breakdowns and includes recommendations for WAGD and instrument
air in spaces where those services are applicable.
44. 12.13.2019
CONCLUSION
Michigan is transitioning to FGI 2018
• FGI is continuously updated with major updates every 4
years
• FGI is more comprehensive and developed to address
evolving health care facility design
• FGI offers “Beyond Fundamentals” series to address Best
Practices in Health Care Design