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Facilities Development Division California’s Building Department for Hospitals Paul A. Coleman, Architect, Deputy Director Chris Tokas, S.E., Deputy Division Chief Gordon Oakley, Fire Marshal, Deputy Division Chief Roy Lobo, Ph.D., S.E., Principal Structural Engineer Glenn Gall, Supervisor, Building Standards Unit Nanci Timmins, Fire Marshal, Chief Fire Life Safety Officer California Healthcare Association August 8, 2017 1
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Page 1: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Paul A. Coleman, Architect, Deputy DirectorChris Tokas, S.E., Deputy Division Chief

Gordon Oakley, Fire Marshal, Deputy Division ChiefRoy Lobo, Ph.D., S.E., Principal Structural Engineer

Glenn Gall, Supervisor, Building Standards UnitNanci Timmins, Fire Marshal, Chief Fire Life Safety Officer

California Healthcare AssociationAugust 8, 2017

1

Page 2: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

In Case You Haven’t Heard

2

We’ve Moved!Approved as noted

Page 3: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Plan Review and Field Performance Update

3

Page 4: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Workload Summary/Performance

4

Page 5: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

No. of Reviews Year 2016

65%

35%

≈ 59 reviews/day

5

Page 6: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Project Plan Review Data Analysis 2st Qtr. 2017

68% of the Plan Reviews are completed w/in 21 days or less

Σ=552 or 14% of All Projects

92% of the PAD Reviews are completed w/in 21 days or lessOr 40% of Office Plan ApprovalReviews

6

62%

35%

≈ 62 reviews/day

Page 7: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Number of Permits – 4th Qtr. 2010 thru 2nd Qtr. 2017

7

758

669

745

471504 494 510

557

470

549586 595

512 500

601640

589630

694664

614 630

730

639603 594

644

285

0

100

200

300

400

500

600

700

800

Num

ber o

f Per

mits

Quarter-Year

Statewide combined Office and Field Number of Permits Issued by Quarter

724

582

With SB 1838 Permits

Without SB 1838 Permits

Page 8: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Workload in Construction Values for projects in Construction - % Completion

8%26%65%

(1st Qtr. 2017 Numbers)

8

66% 28% 9%

Page 9: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

117107

115

58

91

7668

74 7570

38

5345

30

43

3018

3022 22 19

1318

2516 14

6 7

0

20

40

60

80

100

120

140

Num

ber o

f Per

mits

Quarter-Year

Number of SB 1838 Projects – 2nd Qtr. 2017

Statewide Number of SB 1838 EXEMPT Projects Approved by Quarter

113

40

9

Page 10: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Workload in Construction Values for projects in Pending Construction State By Region

10

$0.0B$0.1B$0.2B$0.3B$0.4B$0.5B$0.6B$0.7B$0.8B$0.9B$1.0B

CentralRegion

CoastalRegion

NorthRegion Rapid

ReviewUnit

North LosAngelesRegion

South LosAngelesRegion

SouthRegion Sum

$0.1B$0.2B

$0.1B$0.0B

$0.2B

$0.1B$0.2B

$0.9B

Total = $12,608,359,949

Page 11: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Seismic Compliance Update

Page 12: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Structure Performance Categories

* Based on 2001 Hospital Survey Results based on hospital “self-report” and then “state-of-the-art” FEMA 178 standards from 1996** SPC-5 includes buildings currently under constructionFor SPC - "Not Assigned" is for non-building structures such as equipment yards, cooling towers etc that are still under construction

Page 13: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Hospital Seismic Compliance to Date

217 7/28/17

1096

Bui

ldin

gs 8

3.5%

< 2½ years left

Page 14: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Nonstructural Performance Categories

***Includes buildings under construction, tunnels and equipment yardsFor NPC - "Not Assigned" are for buildings and nonbuilding structures either under construction or where the nonstructural performance category has not been verified

Page 15: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

2017 SB499 Report Timeline• Building Inventory/SB499 Preparation Letter – 6/27/17• Building Inventory/SB499 Preparation Reminder Letter –

7/25/17• Building Inventory Revisions cutoff deadline – 7/28/17• Release of Online Report with passwords – 8/21/17• Online Report Reminder Letter – 9/25/17• Online Report Warning Letter – 10/16/17• Online Report submittal deadline – Wednesday, 11/1/17• OSHPD Website Final Report posting deadline 2/1/18

Page 16: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Project Closure and Invoicing

Page 17: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Projects Awaiting Final Costs from Clients; Number of Projects by OSHPD Region

• Projects waiting for final client costs

• The distribution of projects in the time waiting stays relatively consistent.

Projects Awaiting Final Client Cost

No. of Projects5 Month Trend

Page 18: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

As higher valueprojects move into the closure process, the time segments expand and contract as well as the duration of time spent in each time period.

Projects Awaiting Final Client Cost

$ Value5 Month Trend

Page 19: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

The total number of outstanding invoices starting 7/1 and ending in 8/1 jumped 16%.

Status of Accounts Receivable

No. of Open Invoices

Page 20: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

• Total value of unpaid invoices ending in July is $13.5M.

• increase of 17% from June, but down 37% from one year ago at $21M and down 53% from a 2017 high in February of $29M

Status of Accounts Receivable

$ Value Open Invoices

Page 21: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

FDD Income and Expenses

21

$-

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$69,678

$47,619

Thou

sand

s

FDD Year-to-Date Income & Expenses

Income

Expenses

Page 22: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

FDD Income and Expenses

22

$60.61M

$47.62M

$39.41M

$34.07M

$21.21M

$11.89M

$69.34M

0

$10M

$20M

$30M

$40M

$50M

$60M

$70M

$80M

Jul 01 Jul 31 Aug 31 Sep 30 Oct 31 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 May 31 Jun 30

FDD

Budg

et in

Mill

ions

Budgeted Dollars & Expenditure/Encumbrances

Target Budgeted $

Y-T-D Expenditures

Target BudgetedSalaries and Benefits $

Y-T-D Salaries &Benefits Expenditures

Target OE/E Budgeted $

Y-T-D Expenditures &Encumbrances*

Y-T-D Cash Income

Page 23: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

FDD Expenditures FY 2016/17

23

71.50%

11.82%

16.68%

FDD 2016/17 Expenditures thru 6/30/17

Personal Services

General Expenses, I.T., EOC/Equipment & Purchases in Process

OSHPD Overhead - Admin. & I.T.

Page 24: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Facilities Development DivisionCalifornia’s Building Department for Hospitals

eServices

Page 25: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eServices Update

25

This quarter the eSP Team has focused on improving the quality of data being entered into the eServices Portal.

Many of the enhancements occur ‘behind the scenes’ or notify users when certain actions occur:

Page 26: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eServices Update

26

Automated Email Notifications• GeoTech report uploaded to eSP• Plan approval notification to RCO for issuance of BP• Final payment received notification to PT• eRAD notification to RCO• Functional Program notification to CDPH for pharmacy

projects involving sterile or hazardous compounding

Page 27: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eServices Update

27

Automated Letters• For projects approved in the field, plan approval letters

recognize whether the plan was electronic or paper and populates correct processing instructions.

Page 28: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eServices Update

28

Data Improvements and Fixes• BPs are automatically assigned to the RCO, not the

Manager• Projects under an Annual Building Permit are

automatically connected to the ABP Record.• Project Closure Summary report displayed incorrect

status when emailed to clients.

Page 29: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Project & Child Documents Report

29

A new report has been created that lists all documents associated with a project or any of its ‘child’ projects (BPs, ACDs, AMCs etc.). This can be very useful for completion of construction and project close-out.

Page 30: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Project & Child Documents Report

30

The report identifies the records where documents have been uploaded to avoid looking on records where no documents exist.

Page 31: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Project & Child Documents Report

31

Expanding the Record ID lists all documents that have been uploaded to the Attachments section of the record.

Page 32: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Project & Child Documents Report

32

Using this report you can quickly confirm if the required closure documents have been uploaded as well as who uploaded them, when they where uploaded and where they were uploaded.

This report will eventually have hyperlinks to open the document by clicking on the document name. For security purposes, this feature will not be available to non-OSHPD staff.

Page 33: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Project & Child Documents Report

33

This report is currently available in the OSHPD Report Center.

Page 34: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Project List by Region, County, Facility Report

34

Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report is very useful and lists all projects at a facility based on the search criteria entered. The report is currently available in the OSHPD Report Center.

Page 35: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Project List by Region, County, Facility Report

35

The report can be all inclusive or customized to a single facility based on the values selected.

Once generated, the report gives an excellent snapshot of the status of all projects in the search criteria.

Page 36: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eCPR

Auto Codes

e

36

Page 37: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eCPR

37

eCPR was deployed on August 1, 2017.

This new process and record type is used for formal appeals to OSHPD using the Comment and Process Review currently codified in CAC Section 7-161.

Page 38: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eCPR

38

Any person associated with the project may request an appeal using the eCPR. Upon successful completion of the application, the eCPR is automatically routed to the correct reviewer or field staff.The time limitations specified in CAC 7-161 are tracked by eSP; if the first level reviewer does not reply within 10 calendar days, the CPR is automatically escalated to the Supervisor or RCO.

Page 39: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eCPR

39

Acceptance or denial of the appeal is documented with an email and a formal letter which will include the reason for any denial.

If the appellant wishes to escalate to the next level, a hyperlink is provided in the letter which will be automatically addressed to the appropriate next-level individual.

Page 40: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eCPR

40

Example of CPR Results Letter

Page 41: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

eServices Update

41

Next steps:• Field Operations improvements & enhancements• ePC improvements

o Updated rendering engine

o Ability to render-on-demand to create overlay pages for backcheck reviews

Page 42: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Tableau Reports – Report Card

Page 43: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Tableau Reports – Timely Review

Page 44: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Tableau – Timely Traige

Page 45: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Tableau – Workload Analysis by Regions

Page 46: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Tableau – Workload Analysis by Counties

Page 47: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Educational Opportunities

Page 48: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Webinars

48

New Pharmacy Standards/Regulations• CHA Sponsored, including Board of Pharmacy,

CDPH, and FDD

2016 California Building Standards Code• In conjunction with the HBSB

• Fire/life Safety• Administrative Regulations and Architectural, Mechanical

and Electrical• Structural

Page 49: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Webinar on Sterile Compounding Pharmacies

49

# of connections = 231# of participants = 693-924

Page 50: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Webinar on 2016 CBSC Fire and Life Safety Provisions

50

# of connections = 80# of participants = 240-320

Page 51: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Webinar on 2016 CBSC Administrative, Architectural, MEP Systems and Pharmacy Provisions

51

# of connections = 78# of participants = 234-312

Page 52: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Webinar on 2016 CBSC Structural Provisions

52

# of connections = 76# of participants = 228-304

Page 53: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Upcoming Webinars/Seminars

• Proposed Energy Standards (webinar): late August/early September 2017

• PINs and CANs (webinar): November 2017 ?• Mid-Term Code Changes (webinar): February

2018• Repurposing Hospital Buildings (seminar): April

2018• Final Energy Standards (webinar): February 2019

53

Page 54: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Upcoming Webinars/Seminars

Page 55: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Other Stuff

Page 56: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

FDD’s Top 3 Objectives for 2017

56

1. Expand Electronic Plan Review

2. Reevaluate FDD’s Plan Review Performance Goals

3. Develop an IOR Trainee/Apprentice Program

Page 57: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

HBSB Stuff

DATE MEETINGAugust 9, 2017 Technology CommitteeAugust 23, 2017 Energy Conservation and

Management CommitteeSeptember 14, 2017 Administrative Processes, Code

Changes and Standard Details Committee

October 12, 2017 Energy Conservation and Management Committee

Page 58: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

California Building Standards Code Changes

58

Page 59: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

2019 CBC Structural Regulations

• Started preparing for the 2019 Code Adoption process– ASCE 7-16, TMS-402/602-16, AISC-360/341-16 are

all published– IBC 2018 slated for publication September, 2017– ASCE 41-17 not included in the IBC/IEBC 2018

• OSHPD plans to incorporate it in 2019 CBC, provided it’s published and available to meet 2019 CBSC adoption Schedule

59

Page 60: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Facilities Development DivisionCalifornia’s Building Department for Hospitals

2016 Intervening Code Adoption Cycle

Page 61: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

California Building Code Changes

61

× ×

Page 62: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

California Building Code Changes

62

Page 63: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

California Building Code Changes

• CAC, CBC, CEC, CMC and CPC proposed code changes submitted and processed through the code advisory committees and subsequent public comment periods

• Proposals – Psychiatric Functional Program Element– Alignment of Fees with Statute– Technology and Medical Communications– Acute Psychiatric Hospitals– Adoption of ASHRAE 170

63

Page 64: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Subsequent Actions/Comments Received

• CBC provisions – 1224.39 Outpatient Observation Units

• OSHPD withdrawal of the originally proposed provisions regarding outpatient observation units for further study

– 1228 Acute Psychiatric Hospital provisions • Positive comments received• Resulted in an additional 15 day change for two

clarifications to the original proposal.

64

Page 65: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Subsequent Actions/Comments Received

• CMC provisions– Integrated previously adopted California provisions

into the newly adopted model code - ASHRAE 170. – Majority of comments, while numerous, were on

previously adopted and substantiated language solely brought forward and reformatted into ASHRAE 170 including the ventilation table.

• These comments are considered "outside of the rule making” and resulted in no change to the original proposal

65

Page 66: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Outpatient Observation Unit

66

1253.7. (a) For purposes of this chapter, “observation services” means outpatient services provided by a general acute care hospital and that have been ordered by a provider, to those patients who have unstable or uncertain conditions potentially serious enough to warrant close observation, but not so serious as to warrant inpatient admission to the hospital.

Page 67: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Outpatient Observation Unit• Original Proposed Language - Withdrawn

67

✔✔

These requirements fall under the 2016 CBC section:

1224.33 EMERGENCY SERVICES

- 1224.33.5 Other Space Considerations

- 1224.3.5.1 Observation Units

Page 68: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Outpatient Observation Unit• Original Proposed Language – Referenced Requirements

68

1224.33.5 Other space considerations.1224.33.5.1 Observation units. Observation rooms for the monitoring of patients up to 24 hours may be provided as a distinct unit within the emergency department. If provided the unit shall have the following:

1. Handwashing stations shall be provided in each patient room or for each four treatment stations or major fraction thereof

2. Each patient station shall have a minimum of 120 square feet (11.15 m2) of clear floor area

3. One toilet room shall be provided for each six treatment stations or major fraction thereof

4. An administrative center/nurse station

5. A nourishment area

Page 69: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Outpatient Observation Unit• SB 1076 Intent

69

Definition and Purpose:• SB 1076 defines “observation services” as “outpatient services… to those

patient who have unstable or uncertain conditions potentially serious enough to warrant close observation, but not so serious as to warrant inpatient admission to the hospital.”

• Observed acuity should be less than what would be readily apparent for immediate inpatient admission.

Potential Use: Patient Type 1 - New patient:

o Outpatient Observation only (with no admission)o Outpatient Pre-Admission

Patient Type 2 - Existing patient:o Outpatient Post-Discharge

Page 70: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Outpatient Observation Unit• SB 1076 Intent

70

Required Services – may include the use of:• A bed

• Monitoring by nursing and other staff

• Any other services that are reasonable and necessary to safely evaluate a patient’s condition or determine the need for a possible inpatient admission to the hospital

Question:

What is implied by “reasonable and necessary” for patients currently at an outpatient status with the potential for inpatient admission?

Page 71: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Outpatient Observation Unit• SB 1076 Intent

71

Analysis - Patient Station: 1988 - 2001 CBC 2016 CBC(effective thru 12/31/2006)

Nursing Unit

Single Patient Room 110 sf 120 sf(3 feet clear @ sides

and foot of bed)(3 feet clear @ sides and

foot of bed)

Mullti-Patient Room 80 sf / bed 100 sf / bed(3 feet clear between

beds & 4 feet @ foot of bed)

(3 feet clear between beds & 4 feet @ foot of

bed)

Emergency Services

Treatment Room 80 sf 120 sf single or 80 sf/multi-gurney

(the least dimension shall be 8')

(3 feet clear @ sides and foot of bed/gurney)

Observation Room No Stated Size 120 sf

Page 72: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Outpatient Observation Unit• Proposed Language Revisions

72

Patient Care Space:120 sf per patient 110 sf single or 80 sf multiple patients

Negative Pressure Isolation:Optional patient isolation provisions defined

Time Limitation:Reference to 24 hour maximum not included

Location:Corridor systems shall connect unit to all Basic and Supplemental Services

Utility Services Infrastructure:Nurse call, emergency power, and portable oxygen

Page 73: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Outpatient Observation Unit• Proposed Language Revisions

73

Defined Service Areas to Support a Stand-Alone Unit:• Supervisor Office

• Staff Toilet(s)

• Multipurpose Room(s)o Conferenceso Reportso Trainingo Consultation

• Examination or Treatment Rooms

• Medication Stations

• Nourishment Areas and Ice Machine(s)

• Clean and Soiled Utility Support Spaces

• General and Emergency Equipment Storage / Gurney & Wheelchair Storage

Page 74: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

Next Steps

• Next Steps

Client Review

Comment Period

PIN Development

HBSB Committee

CBSC Adoption

74

Page 75: Facilities Development Division · Project List by Region, County, Facility Report 34 Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report

75


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