The 2022 FGI Guidelines for Design and Construction are here. Updates to these standards are released every four years. In this newest edition, the Facility Guidelines Institute (FGI) offers three guidelines publications for:  

1. Hospitals
2. Outpatient facilities
3. Residential health, care, and support facilities.

Each publication is a valuable resource for facility planning and design. The guidelines incorporate information to inform design of spaces, programs, facility risk assessment, infection prevention, and project details. 

The underlying theme throughout the 2022 FGI guidelines is a focus on patients. Design is integral to patient experience, level of care, and ease of care provided by caregivers and the guidelines encourage design flexibility, innovation in patient care, and ensuring staff welfare. 

(2022 Hospital | 2.1-1.1.3 Non-Traditional Application) 

Healthcare facilities are often at the forefront of the latest practices and technology, with new spaces continually added and old spaces reconfigured often. To accommodate the ever-changing nature of hospitals, implementing the guidelines does not always align with the scope of a particular project.  Designers must identify early in the design which sections of the guidelines are being applied to the project in order to use this alternate method. 

(2022 Hospital | 2.2-2.9 Neonatal Intensive Care Unit) 

Overall, the square footage of newborn intensive care unit (NICU) rooms increased. As NICU spaces are designed, the design team should coordinate closely with the architect and owner to confirm the number of bassinets and locations within each room. 

A significant change in the hospital guidelines is the removal of the free-standing emergency care facilities chapter. This chapter will now only be featured in the outpatient guidelines.  

Emergency facilities must have “video surveillance at public entrances and a duress alarm system where ED entrances” can be locked.  

A substantial impact on plumbing systems is the reduction of permissible non-recirculated fixture branch piping in hospitals from a maximum of 25 to 10 feet. This will impact the domestic water design requirements, especially in patient care spaces.  

(2022 Hospital | 2.1-8.42.5 Heated potable water distribution) 

FGI Outpatient Guidelines 

The 2022 outpatient guidelines encourage space use flexibility.  

With an increased focus on mental health and behavioral care, the spaces’ safety risk assessment requirements are being updated to require the review of each space type and associated risk levels by the design team.

(2022 Outpatient | 1.2-4.6 Behavioral and Mental Health Risk Assessment) 

In the common elements chapter, the single-patient exam/observation room minimum square footage has increased to 100 square feet (approximately the area of an apartment bedroom), meaning the ventilation loads of these spaces will increase in parallel.  

(2022 Outpatient | 2.1-3.2.2.2 Single-patient exam/observation room) 

A minimum of one single-patient exam room must now be included in urgent care facilities. With these updated guidelines, the trauma rooms can be split and accommodate treatment stations serving low-acuity patients. This flexibility could lead to increased capacity for patients during a surge and saveprivate rooms for more severe cases. 

(2022 Outpatient | 2.5 Specific Requirements for Urgent Care Centers) 

For renal dialysis centers, new requirements are included for fluid disposal sinks in hemodialysis treatment areas.  

(2022 Outpatient |2.10 Specific Requirements for Renal Dialysis Centers) 

In the birth centers chapter, the birth room square footage has been decreased. This will reduce the ventilation required for these spaces and potentially increase the number of rooms that can fit on a floor plate.  

(2022 Outpatient |2.4 Specific Requirements for Birth Centers) 

Room and pressure guidelines for dental labs now align with the requirements set forth in ANSI/ASHRAE/ASHE Standard 170, Ventilation of Health Care Facilities.  

(2022 Outpatient |2.14 Specific Requirements for Dental Facilities) 

FGI Residential Guidelines  

The 2022 Residential guidelines were reorganized to align with the hospital and outpatient guidelines. In the new common elements chapter, sustainability guidelines have been reworked to refer to standards. This chapter now includes kitchen and dining area requirements. This includes a focus to improve acoustics in residential dining settings.  

Key Takeaways 

Overall, the 2022 guidelines have been updated to provide for flexible space use. Have questions on how these latest FGI 2022 changes will affect renovations or new projects at your facility? Contact Henderson to learn how we can assist.  

Additional References 

FGI Guidelines
ASHE
AIA KnowledgeNet
Mechanical Construction & Design
HFM Magazine