Haines and Griffin/Office Space Planning, Part 3

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tifying boundaries, utilities, easements, topography, and

ing design. It is important to note that the building

other site features. Sub-surface soils investigations will

code is a collection of minimum requirements; often,

need to be performed to determine the type of foundation

sound engineering and architectural practice will ex-

system that is suited to your project. Local codes and or-

ceed these requirements.

dinances and the process for approvals are researched.

· Department of Health: This department or other sim-

ilarly named state agency will review plans for some

types of medical facilities such as ambulatory surgery

Medical architecture is not about building

centers, nursing homes, or another type of facility where

buildings; it is about building practice space

the occupants may not be capable of self-preservation.

and manipulating workflow patterns.

This department may have its own set of regulations or

will have adopted the regulations of widely published

guidelines such as the American institute of Architects

For a renovation or tenant up-fit project, "as-built"

(AIA) Guidelines for Design and Construction of

documents and drawings are needed. After the basic pa-

Hospital and Health Care Facilities. These documents

rameters of the project are defined, the design process will

will often refer to other codes and standards, as well.

start in earnest. The next step is the schematic design

This can create a long list of requirements that unfor-

phase.

tunately are sometimes in conflict with one another.

Regulations

Federal Requirements. Two of the federal re-

quirements that will impact your design are the ADA and

Many aspects of your facility are regulated through

the Health Information Portability and Accountability

various building codes, zoning ordinances, and federal

Act (HIPAA). The ADA defines what needs to be done to

and state requirements. Your design team will help guide

accommodate persons with disabilities. For facility design,

you with decisions relating to each of these. However, a

it largely requires all spaces to be wheel chair accessible

basic understanding of what these mean to your devel-

(for patients, staff and doctors) or to be readily adaptable.

opment is important to have. Let's start with the local

Many states have developed accessibility codes that are

regulations and then broaden that to the state and fed-

more stringent than the ADA.

eral levels.

HIPAA concerns itself with patient confidentiality

Local. Each locality will have different bodies and

particularly in regards to access to the medical record. For

governmental agencies that will interact with you and your

your facility design, this may mean that the medical record

construction team on your project. These include:

files will need to be securable from unauthorized access.

· Zoning and Development: This department will de-

It also means that close attention be paid to the manner

termine if the land is zoned correctly for the use you

that patients are registered and checked out of your facil-

intend and what specific requirements must be met on

ity to prevent others from overhearing sensitive conver-

the land usage. This generally includes parking re-

sations. Even the orientation of computer screens becomes

quirements, building setbacks, height and area restric-

important.

tions, landscaping requirements, and buffers (typically

As mentioned earlier, the design of the facility, both

required adjacent to residential areas).

in plan arrangement and in construction details, will need

· Engineering Department: This department will have

to address sound attenuation, particularly in patient con-

specific requirements on storm water management,

tact areas.

water metering, sewer connections, and driveway de-

Compliance with the various regulations and re-

sign and location.

quirements is a time-consuming part of the design process.

· Fire Marshal: The fire marshal will review your plans

Nonetheless, occupancy of projects has been delayed

to determine how the fire-fighting apparatus can be

through inappropriate interpretation of the codes. For

deployed. They will also review your sprinkler design

these reasons, it is important that the local and state re-

and fire exits. In some states, both a local and a state

viewers should be consulted early in the design process

fire marshal will review your plans.

to solicit their input and keep them informed of the de-

· Building Department: The building department will

cisions being made on your project.

review your plans, issue the building permit, and in-

spect the project at different stages of construction.

Schematic Design

Typically, this department is charged with interpreting

and enforcing the building code. The Building Code is

The design of a well-functioning medical office build-

a comprehensive set of requirements on how a build-

ing requires the talents of both a skilled medical planner

ing must be designed. It includes such things as height

and a skilled architect. Sometimes this is the same person,

and area limitations, allowable construction materials,

but more often, two different design teams perform these

exiting, fire resistance, and minimum design require-

tasks. The medical planner is responsible for protecting

ments for structural, mechanical, electrical, and plumb-

the integrity of the medical plan: patient flow, staff flow,