Section 518.2240  Building Requirements

 

a)         Location

            The freestanding emergency center shall be conveniently accessible to the population served.  In selecting location, consideration shall be given to factors affecting source and quantity of patient load, including highway systems, public transportation, industrial plants, and recreational areas.

 

b)         Parking

            One parking space for each staff member on duty at any one time and no fewer than two spaces for each major procedure room and each observation/treatment room shall be provided.  Handicapped parking spaces shall be provided as required in the Illinois Accessibility Code (77 Ill. Adm. Code 400). Additional spaces shall be provided for emergency vehicles.  Street, public, and shared lot spaces shall be exclusive for the use of the emergency facility. All required parking spaces shall be conveniently located to the emergency entrance.

 

c)         Administration and Public Areas

 

1)         An entrance shall be located at grade level and be able to accommodate wheelchairs.

 

A)        All entrances shall be covered to permit protected transfer of patients from ambulances, and a ramp for wheelchairs and stretchers shall be provided in addition to steps.  Doors to emergency services shall be not less than 4 feet wide.

 

B)        The emergency entrance shall have vision panels to minimize conflict between incoming and outgoing traffic and to allow for observation of the unloading area from the control station.

 

2)         A lobby and waiting area shall be provided and shall provide:

 

A)        convenient access to wheelchairs and stretchers;

 

B)        a control station that may be used for triage functions, is in direct communication with medical staff and has direct visual control of the emergency entrance, observation of arriving vehicles, and access to treatment and lobby areas;

 

C)        waiting areas convenient to the reception and interview areas;

 

D)        public toilet facilities for males and females.

 

3)         Facilities for conducting interviews with patients and others shall be provided and shall include provisions for acoustical privacy.

 

4)         General and individual offices shall be provided.

 

5)         Clerical spaces shall be provided.

 

6)         Multipurpose rooms for staff conferences and consultation shall be provided.

 

7)         Equipment and general storage areas shall be provided.

 

d)         Clinical Facilities

 

1)         At least one major procedure room shall be provided and shall meet the following requirements:

 

A)        a minimum clear area of 360 square feet exclusive of cabinets, shelves, door swings and fixed obstructions;

 

B)        a minimum clear dimension of 16 feet;

 

C)        if laser equipment is to be used, the square footage of this room is to be increased to a clear area of 400 square feet;

 

D)        emergency communication equipment connected to the control station;

 

E)         x-ray film illuminator;

 

F)         mechanical and electrical systems and devices that meet requirements for hospital surgical rooms in the Hospital Licensing Requirements (77 Ill. Adm. Code 250).

 

2)         Where additional major procedure rooms are set up for multi-patient use, these rooms shall meet the following requirements:

 

A)        a minimum clear area of not less than 180 square feet per patient stretcher or bed;

 

B)        a minimum clear dimension of 10 feet per space;

 

C)        emergency communication equipment connected to the control station;

 

D)        x-ray film illuminator;

 

E)         mechanical and electrical devices that meet requirements for hospital surgical rooms in the Hospital Licensing Requirements (77 Ill. Adm. Code 250).

 

3)         A holding area for stretchers and wheelchairs within the clinical area shall be provided away from traffic and under staff control.

 

4)         A poison control service shall be provided that contains the following services:

 

A)        immediately accessible antidotes;

 

B)        a file of common poisons; and

 

C)        communications links with regional and national poison centers and regional  EMS centers.

 

5)         A nurses' work and control station shall be located to permit visual control and access to clinical areas and shall contain space and equipment to allow the following services to be provided:

 

A)        charting;

 

B)        storage of files;

 

C)        staff consultation; and

 

D)        communication link with exam/treatment, trauma/cardiac, reception control, laboratory, radiology, on-call staff.

 

6)         A CPR emergency cart shall be located away from traffic and available to all areas.

 

7)         Scrub stations shall be provided at each trauma/cardiac room with water and soap controls operable without the use of hands.

 

e)         Radiology

 

1)         Facilities for basic diagnostic radiological procedures shall be provided and shall include the following elements:

 

A)        a size adequate to accommodate needed equipment with a minimum clearance of 3 feet on all four sides of the table;

 

B)        a shielded control alcove with windows providing a full view of the examination table and the patient; and

 

C)        a patient toilet accessible from the radiographic room.

 

2)         Film processing facilities shall be provided.

 

3)         Viewing and administrative areas shall be provided.

 

4)         Storage facilities for exposed film shall be provided.

 

5)         Dressing rooms or booths with convenient toilet access shall be provided.

 

f)          Laboratory

 

1)         Laboratory Facilities shall be provided for the performance of tests in hematology, clinical chemistry, urinalysis, microbiology, anatomic pathology, and cytology to meet the workload described in the functional program.

 

2)         Provisions shall be made for the following procedures to be performed on-site:  blood counts, urinalysis, blood glucose, electrolytes, blood urea and nitrogen (BUN), coagulation, and transfusions (type capability). If transport time by an ambulance to the nearest hospital is 10 minutes or less, plasma expanders may be used.  If transport time by ambulance to the nearest hospital is greater than 10 minutes, then type O negative blood must be available for transfusion.  Provisions shall also be included for specimen collection and processing.

 

3)         The following shall be provided in the laboratory suite:

 

A)        Work counters with space for items such as microscopes, chemical analyzers, incubators, and centrifuges; work counters shall include sinks and provisions for fluid disposal, eye washes, vacuum, gases, electrical services, and piped-in air;

 

B)        Hand-washing lavatories operable without the use of hands at strategic locations for convenience of use;

 

C)        Storage facilities;

 

D)        Chemical safety provisions including emergency showers, eye-flushing devices, and blankets; floor drains at the emergency shower locations;

 

E)         Flammable liquid storage in the form of vented cabinets designed for use with flammable liquids;

 

F)         Specimen collection facilities including:  blood collection area with work counter, space for patient seating and hand washing (operable without the use of hands); a urine and feces collection room equipped with water and lavatory;

 

G)        A terminal sterilization facility for contaminated specimens (autoclave or electric oven), unless contaminated waste is disposed of through a licensed waste management service in accordance with Section 518.2150(f)(4); and

 

H)        If radioactive materials are employed, facilities for long-term storage and disposal of these materials, appropriately shielded to prevent exposure.

 

g)         Staff locker rooms and toilets shall be provided.

 

h)         At least one housekeeping room per floor shall be provided.  It shall contain a service sink and storage for housekeeping supplies and equipment.

 

i)          Utility Rooms

 

1)         A clean utility room shall be provided and contain the following:

 

A)        storage for clean and sterile supplies and equipment;

 

B)        work counters;

 

C)        hand-washing sinks operable without the use of hands;

 

D)        ice maker;

 

E)         under-counter refrigerator; and

 

F)         communications equipment.

 

2)         A soiled utility room shall be provided and contain the following:

 

A)        storage for soiled supplies and equipment;

 

B)        work counters;

 

C)        hand-washing sinks operable without the use of hands;

 

D)        communications equipment; and

 

E)         clinical service sink.

 

j)          Sterile supply and processing rooms shall be provided and may be combined with the clean and soiled utility rooms if the program narrative is approved.

 

1)         One-way flow shall be maintained between the soiled supplies, clean up, sterilizing, and storage functions.

 

2)         Storage spaces for clean and sterile supplies and equipment shall be provided.

 

3)         Storage spaces for soiled supplies and equipment shall be provided.

 

4)         There shall be no direct access between the soiled and clean sides of sterile supply and processing.

 

5)         Work counters and hand-washing sinks operable without the use of hands shall be provided.

 

6)         A clinical service sink shall be provided on the soiled side.

 

7)         The soiled side shall have equipment for cleaning such as ultrasound, washers, and deep three-compartment sink and tray assembly.

 

8)         A pass-through sterilizer shall be provided.

 

9)         Space shall be provided in the soiled side for processing equipment and tray assembly such as steris machines, dryers, tube racks, wrapping and labelling counters.

 

k)         A nourishment room for the use of patients, conveniently located to the clinical area, shall contain the following:

 

1)         work counter;

 

2)         refrigerator;

 

3)         ice maker;

 

4)         hand-washing sink operable without the use of hands; and

 

5)         storage for supplies.

 

l)          Facilities shall be provided for holding  patients until they can be transferred to an appropriate hospital.  The size and type of equipment shall be what is required for anticipated patient load and lengths of stay.  Each observation bed shall provide for:

 

1)         direct visual observation of each patient from the nurses' station;

 

2)         patient privacy;

 

3)         access to patient toilets;

 

4)         secure storage of patients' belongings;

 

5)         medication dispensing;

 

6)         bedpan storage and cleaning;

 

7)         hand-washing facilities without the use of hands;

 

8)         communications system with nurses station; and

 

9)         monitoring capabilities.

 

m)        A consultation/communications room shall be located within access of the diagnostic and treatment facilities and provide sound isolated for privacy and confidentiality of consultation for the use of the staff during the tele-medicine consultation.  The room shall contain the following:

 

1)         computer support and telecommunications support equipment necessary for the consultation task;

 

2)         view screens;

 

3)         work counters;

 

4)         storage areas; and

 

5)         additional refrigeration units as required by equipment.

 

n)         Mobile Transportable Diagnostic Units

 

1)         If used, the size of mobile transportable diagnostic units shall limit occupancy and therefore minimize life safety hazards.  These units shall be restricted to the following:

 

A)        minimum construction of one-hour protected wood frame;

 

B)        built-in smoke detectors and sprinkler systems;

 

C)        a two-hour fire separation from the freestanding emergency center;

 

D)        a maximum clear area of 1,000 square feet; and

 

E)         a maximum occupancy of two patients and not more than six persons at any one time.

 

2)         Site conditions shall be a consideration in placement of the units.  The following elements shall be included in the siting of the unit:

 

A)        turning radius of vehicles, slopes of approach (6% min.), existing conditions;

 

B)        gauss fields of MRI Units, and radio frequency interference;

 

C)        properly sized power, including emergency power, water, waste, telephone, fire alarm connections;

 

D)        level concrete pads or piers designed for the structural loads of the facility;

 

E)         adequate access for cryogen storage units in the case of MRIs;

 

F)         covered walkway or enclosure to ensure patient safety from the outside elements;

 

G)        diesel exhaust from the tractor unit and/or generator must be kept away from the fresh air intake of the facility; and

 

H)        pad anchors and wheel blocks to stabilize unit and prevent movement.

 

3)         A room for transition access between the portable unit and the center shall be provided and shall contain the following:

 

A)        two-hour separation between the exterior wall of the center and the mobile unit;

 

B)        hand-washing sink;

 

C)        protection from the elements;

 

D)        equipment storage;

 

E)         communications with control station; and

 

F)         patient toilet.