Neufert Hospital Standards

[Ling Baus]

Thisdocument provides guidelines for designing hospital facilities, including general organization, specialized services, and safety standards. It discusses key aspects such as the appropriate area and layout, orientation of treatment zones, number of beds, and relationships between services. Specialized sections cover requirements for surgical units, postoperative care, intensive treatment, radiology, and other services. Circulation and accessibility for patients and staff are also addressed. The document aims to help planners design hospitals that meet operational and regulatory needs.Read less

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This document presents uniform standards for the design, construction and alteration of buildings so that physically handicapped persons will have ready access to and use of them in accordance with the Architectural Barriers Act, 42 U.S.C. 4151-4157. The document embodies an agreement to minimize the differences between the standards previously used by four agencies (the General Services Administration, the departments of Housing and Urban Development and Defense, and the United States Postal Service) that are authorized to issue standards under the Architectural Barriers Act, and between those standards and the access standards recommended for facilities that are not federally funded or constructed.

The four standard-setting agencies establish and enforce standards for design, construction, and alteration of particular types of buildings and facilities. The General Services Administration (GSA) prescribes standards for all buildings subject to the Architectural Barriers Act that are not covered by standards issued by the other three standard-setting agencies; the Department of Defense (DoD) prescribes standards for DoD installations; the Department of Housing and Urban Development (HUD) prescribes standards for residential structures covered by the Architectural Barriers Act except those funded or constructed by DoD; and the U.S. Postal Service (USPS) prescribes standards for postal facilities. Each of the four agencies issues standards in accordance with its statutory authority.

To ensure compliance with the standards, Congress established the Architectural and Transportation Barriers Compliance Board (ATBCB) in Section 502 of the Rehabilitation Act of 1973 (the Rehabilitation Act), 29 U.S.C. 792.

The ATBCB is composed of members representing eleven Federal agencies (the four standard-setting agencies; the departments of Education, Health and Human Services, Interior, Justice, Labor, and Transportation; and the Veterans Administration) and eleven members appointed by the President from the general public. A 1978 amendment to Section 502 of the Rehabilitation Act added to the ATBCB's functions the responsibility to issue minimum guidelines (Guidelines) and requirements for the standards established by the four standard-setting agencies. The final rule that established the Guidelines now in effect was published in the FEDERAL REGISTER on August 4, 1982 (47 FR 33862) and is codified at 36 CFR part 1190.

The four standard-setting agencies determined that the uniform standards adopted by them would, as much as possible, not only comply with the Guidelines adopted by the ATBCB but also be consistent with the standards published by the American National Standards Institute (ANSI) for general use. ANSI is a nongovernmental national organization that publishes a wide variety of recommended standards. ANSI's standards for barrier-free design are developed by a committee made up of 52 organizations representing associations of handicapped people, rehabilitation professionals, design professionals, builders, and manufacturers. The standards, which are called ANSI Al17.1, "Specifications for Making Buildings and Facilities Accessible to, and Usable by, Physically Handicapped People," are developed using the consensus process.

The original ANSI A117.1, adopted in 1961, formed the technical basis for the first accessibility standards adopted by the federal government and most state governments. The current edition, ANSI A117.1-1980, is based on research funded by HUD. It has generally been accepted by the private sector and has been recommended for use in model state and local building codes by the Council of American Building Officials.

In keeping with the objective of uniformity between federal requirements and those commonly applied by state and local governments, the Uniform Federal Accessibility Standards (UFAS) follows ANSI A117.1-1980 in format. Both the UFAS scope provisions, which establish the minimum number of elements and spaces required to comply with standards, and the UFAS technical requirements meet or exceed the comparable provisions of the Guidelines.

The UFAS was published in the FEDERAL REGISTER on August 7, 1984 (49 FR 31528). Each of the standard-setting agencies has taken action in accordance with its own procedures, including internally prescribed rulemaking and the Administrative Procedure Act where applicable, to incorporate the UFAS in its own standards, regulations, or other directives. GSA adopted the UFAS in 41 CFR 101-19.6, effective August 7, 1984. HUD adopted the UFAS in 24 CFR part 40, effective October 4, 1984. USPS adopted the UFAS in Handbook RE-4, "Standards for Facility Accessibility by the Physically Handicapped," effective November 15, 1984. DoD adopted the UFAS by revising Chapter 18 of DoD 4270.1-M, "Construction Criteria," by memorandum dated May 8, 1985.

[Note: Handbook RE-4, was amended effective April 16, 1986, by the addition of Interim Standards, Section 4.1.8, "Accessible Buildings: Leasing of Space in Existing Buildings." While Handbook RE-4, not UFAS, sets forth the governing standards for Postal facility accessibility. Handbook RE-4 may be further amended.]

This document sets standards for facility accessibility by physically handicapped persons for Federal and federally-funded facilities. These standards are to be applied during the design, construction, and alteration of buildings and facilities to the extent required by the Architectural Barriers Act of 1968, as amended.

The text of these standards does not contain notes or footnotes. Additional information, explanations, and advisory materials are located in the Appendix. Paragraphs marked with an asterisk have related, nonmandatory material in the Appendix. In the Appendix, the corresponding paragraph numbers are preceded by an A.

The following terms shall, for the purpose of these standards, have the meaning indicated in this section.access aisleAn accessible pedestrian space between elements, such as parking spaces, seating, and desks, that provides clearances appropriate for use of the elementsaccessibleA site, building, facility, or portion thereof that complies with these standards and that can be approached, entered, and used by physically disabled peopleaccessible elementAn element specified by these standards (for example, telephone, controls, and the like)accessible routeA continuous unobstructed path connecting all accessible elements and spaces in a building or facility. Interior accessible routes may include corridors, floors, ramps, elevators, lifts, and clear floor space at fixtures. Exterior accessible routes may include parking access aisles, curb ramps, walks, ramps, and lifts.accessible spaceSpace that complies with these standardsadaptabilityThe ability of certain building spaces and elements, such as kitchen counters, sinks, and grab bars, to be added or altered so as to accommodate the needs of either disabled or nondisabled persons, or to accommodate the needs of persons with different types or degrees of disabilityadditionAn expansion, extension, or increase in the gross floor area of a building or facilityadministrative authorityA governmental agency that adopts or enforces regulations and standards for the design, construction, or alteration of buildings and facilitiesalterationAs applied to a building or structure, means a change or rearrangement in the structural parts or elements, or in the means of egress or in moving from one location or position to another. It does not include normal maintenance, repair, reroofing, interior decoration, or changes to mechanical and electrical systems.assembly areaA room or space accommodating fifty or more individuals for religious, recreational, educational, political, social, or amusement purposes, or for the consumption of food and drink, including all connected rooms or spaces with a common means of egress and ingress. Such areas as conference rooms would have to be accessible in accordance with other parts of this standard but would not have to meet all of the criteria associated with assembly areas.automatic doorA door equipped with a power-operated mechanism and controls that open and close the door automatically upon receipt of a momentary actuating signal. The switch that begins the automatic cycle may be a photoelectric device, floor mat, or manual switch mounted on or near the door itself (see power-assisted door).circulation pathAn exterior or interior way of passage from one place to another for pedestrians, including, but not limited to, walks, hallways, courtyards, stairways, and stair landingsclearUnobstructedcommon useRefers to those interior and exterior rooms, spaces, or elements that are made available for the use of a restricted group of people (for example, residents of an apartment building, the occupants of an office building, or the guests of such residents or occupants)cross slopeThe slope that is perpendicular to the direction of travel (see running slope)curb rampA short ramp cutting through a curb or built up to itdwelling unitA single unit of residence which provides a kitchen or food preparation area, in addition to rooms and spaces for living, bathing, sleeping, and the like. A single family home is a dwelling unit, and dwelling units are to be found in such housing types as townhouses and apartment buildings.egress, means ofAn accessible route of exit that meets all applicable code specifications of the regulatory building agency having jurisdiction over the building or facilityelementAn architectural or mechanical component of a building, facility, space, or site, eg., telephone, curb ramp, door, drinking fountain, seating, water closet.entranceAny access point to a building or portion of building or facility used for the purpose of entering. An entrance includes the approach walk, the vertical access leading to the entrance platform, the entrance platform itself, vestibules if provided, the entry door(s) or gate(s), and the hardware of the entry door(s) or gate(s). The principal entrance of a building or facility is the main door through which most people enter.essential featuresThose elements and spaces that make a building or facility usable by, or serve the needs of, its occupants or users. Essential features include but are not limited to entrances, toilet rooms, and accessible routes. Essential features do not include those spaces that house the major activities for which the building or facility is intended, such as classrooms and offices.extraordinary repairThe replacement or renewal of any element of an existing building or facility for purposes other than normal maintenancefacilityAll or any portion of a building, structure, or area, including the site on which such building, structure or area is located, wherein specific services are provided or activities performedfull and fair cash value Full and fair cash value is calculated for the estimated date on which work will commence on a project and means: The assessed valuation of a building or facility as recorded in the assessor's office of the municipality and as equalized at one hundred percent (100%) valuation, or The replacement cost, or The fair market value. functional spacesThe rooms and spaces in a building or facility that house the major activities for which the building or facility is intendedhousingA building, facility, or portion thereof, excluding inpatient health care facilities, that contains one or more dwelling units or sleeping accommodations. Housing may include, but is not limited to, one and two-family dwellings, apartments, group homes, hotels, motels, dormitories, and mobile homes.marked crossingA crosswalk or other identified path intended for pedestrian use in crossing a vehicular waymultifamily dwellingAny building containing more than two dwelling unitsoperable partA part of a piece of equipment or appliance used to insert or withdraw objects, or to activate, deactivate, or adjust the equipment or appliance (for example, coin slot, pushbutton, handle)physically handicappedAn individual who has a physical impairment, including impaired sensory, manual or speaking abilities, which results in a functional limitation in access to and use of a building or facilitypower-assisted doorA door used for human passage with a mechanism that helps to open the door, or relieve the opening resistance of a door, upon the activation of a switch or a continued force applied to the door itself. If the switch or door is released, such doors immediately begin to close or close completely within 3 to 30 seconds (see automatic door).public useDescribes interior or exterior rooms or spaces that are made available to the general public. Public use may be provided at a building or facility that is privately or publicly owned.rampA walking surface in an accessible space that has a running slope greater than 1:20running slopeThe slope that is parallel to the direction of travel (see cross slope).service entranceAn entrance intended primarily for delivery of services.signageVerbal, symbolic, tactile, and pictorial informationsiteA parcel of land bounded by a property line or a designated portion of a public right-of-waysite improvementLandscaping, paving for pedestrian and vehicular ways, outdoor lighting, recreational facilities, and the like, added to a sitesleeping accommodationsRooms in which people sleep, for example, dormitory and hotel or motel guest roomsspaceA definable area, e.g., toilet room, hall, assembly area, entrance, storage room, alcove, courtyard, or lobby.structural impracticabilityChanges having little likelihood of being accomplished without removing or altering a load-bearing structural member and/or incurring an increased cost of 50 percent or more of the value of the element of the building or facility involvedtactileDescribes an object that can be perceived using the sense of touchtactile warningA standardized surface texture applied to or built into walking surfaces or other elements to warn visually impaired people of hazards in the path of traveltemporaryApplies to facilities that are not of permanent construction but are extensively used or essential for public use for a given (short) period of time, for example, temporary classrooms or classroom buildings at schools and colleges, or facilities around a major construction site to make passage accessible, usable, and safe for everybody. Structures directly associated with the actual processes of major construction, such as porto potties, scaffolding, bridging, trailers, and the like, are not included. Temporary as applied to elements means installed for less than 6 months and not required for safety reasons.vehicular wayA route intended for vehicular traffic, such as a street, driveway, or parking lotwalkAn exterior pathway with a prepared surface intended for pedestrian use, including general pedestrian areas such as plazas and courts4. Accessible Elements And Spaces: Scope And Technical Requirements4.1 Minimum Requirements4.1.1 Accessible Sites And Exterior Facilities: New ConstructionAn accessible site shall meet the following minimum requirements:

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