CSA Z8008:26

Preface This is the first edition of CSA Z8008, Assessments of health care facilities, services, and building systems . It replaces CSA PLUS 317, Guidelines for elementary assessments of building systems in health care projects published in 2000. This Standard is part of the CSA Z8000 series focused on health care facility (HCF) planning, design, and construction. It provides a methodology and format for assessing the condition, performance, suitability, and sustainability of existing building configurations and systems to guide capital infrastructure maintenance and planning. The Standard applies to existing HCFs and non-hospital facilities (NHFs) being considered for future health care service modifications. CSA Group acknowledges that the development of this Standard was made possible, in part, by the financial support of the Governments of Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Nunavut, Ontario, Prince Edward Island, Québec, Saskatchewan, and Yukon, as administered by the Canada’s Drug Agency (CDA-AMC), as well as by the financial support of Standards Council of Canada (SCC). This Standard was prepared by the Subcommittee on Health Care Facilities and Building Systems, under the jurisdiction of the Technical Committee on Health Care Facilities and the Strategic Steering Committee on Health and Well-being, and has been formally approved by the Technical Committee. This Standard has been developed in compliance with Standards Council of Canada requirements for National Standards of Canada. It has been published as a National Standard of Canada by CSA Group. Scope 1.1 General 1.1.1 Assessment framework This Standard provides a framework for the requirements and guidance for a consistent approach on how to plan and conduct functional suitability and technical performance assessments of existing HCFs/NHFs, to determine their ability to support current and future health care service delivery. See Figures 1 a)and 1 b)for this Standard’s organizational structure. 1.1.2 Categories of assessments There are two categories of assessments: a) functional suitability assessments (see Clauses 4.5.2and 6); and b) technical performance assessments (see Clauses 4.5.3and 7). 1.1.3 Types of assessments In each of the two categories of assessments, there are three types of assessments to create a tiered approach, which may be tailored to the purpose of the assessment: a) current state (see Clause 4.6.2); b) gap analysis (see Clause 4.6.3); and c) future state options (see Clause 4.6.4). These types are typically progressive, although not necessarily mutually exclusive. A gap analysis will require that a current state is completed prior to, or as a part of, the gap analysis. Future state options will require some elements of current state and gap analysis information to be available. 1.2 Application This Standard applies to HCFs, including existing hospitals, long-term care homes (LTCH), outpatient HCFs, and NHFs or settings being considered for use in the delivery of health care services. It is intended to be used by HCFs providing services regardless of type, level of care, size, or location. Where applicable by the authority having jurisdiction (AHJ), the focus of the assessment should be aligned with the objectives of the funding agency or study sponsor to identify HCF planning or design issues, to inform capital planning and investment, or to learn from elements of the completed assessments to inform future studies and/or projects. Future studies can include planning, design, and construction (PDC) studies, post-occupancy evaluations (POE), and sustainability or climate resilience plans (see CSA Z8003 for more information on PDC and POE). 1.3 Inclusions, users, and interdisciplinary teams (IDT) This Standard is developed for a broad range of users, including, but not limited to, HCFs, funding agencies, governments, professional design and planning teams, architects, engineers, infection prevention and control professionals (IPC), health care teams, providers and clinical staff, vendors, researchers, and internal and external evaluators. This Standard supports IDT involvement in the assessments, in order to determine the scope of the assessment and to guide an assessment of the functional suitability and the technical performance of the building systems. As applicable, input from health care authorities might also be necessary to establish the assessment purpose and scope. Note: The IDT members of the HCF become the subject matter experts (SMEs) for the assessments and include administrators, health care program and clinical planners, clinical staff, infection prevention and control professionals (ICP), facility operations and maintenance staff, patients and their families, and non-clinical support staff. Other key members of the IDT might include non-HCF individuals (e.g., professional design and planning teams, vendors, funding agencies). 1.4 Objectives 1.4.1 General objectives The general objectives of this Standard are to a) assess the performance of the existing building and/or system’s functional suitability and technical performance and the ability to support the HCF’s health care purposes; b) apprise the HCF or provider of the apparent condition and capacity of the space and systems, identify gaps in performance and associated issues related to the effectiveness of operation and maintenance; c) highlight priority concerns that require in-depth investigations and more detailed information, based on tests, analyses, and reports, such as i) risks and liabilities, including evaluation of risks; ii) life expectancy and deferral of replacements, repairs, or maintenance; iii) environmental impact considerations; iv) sustainability such as greenhouse gas (GHG) emissions, water consumption, effluence, waste management, etc.; and v) accessibility such as public, staff, and care areas for interior and exterior environments; d) add to the facility’s database for asset management, project planning, and recommissioning systems; e) indicate capacity of the facility to accommodate extended service life; and f) assess capacity of the facility to accommodate a proposed change in function. 1.4.2 Business continuity An understanding of the HCF’s business continuity role in the event of the disruption of health care services should be included in the assessment and may include the following: a) number of beds (base plus surge capacity); b) role of the facility in local or regional emergency preparedness system; c) post-disaster requirements; and d) timeline of expected continuation of normal or reduced operations following an event: i) electrical power failure: capacity (hours) of diesel generator fuel storage; ii) information technology/communications failure; iii) failure of site central utilities (heat, cooling, ventilation, medical gases, reverse osmosis, etc.); iv) failure of natural gas to HCF: electric provisions or alternate fuel; v) interruption of roadways/bridges to HCF; vi) failure of incoming water supply: on-site storage capacity; and vii) failure of storm/sanitary outflow: on-site storage capacity. Note: For more information on business continuity/emergency management, see CSA Z8000, CSA Z8002, CSA Z8004, and CSA Z1600. For additional details regarding technical system specific references to business continuity/emergency management, see CSA Z317.1, CSA Z317.2, CSA Z7396.1, CSA Z32, CSA C282, and CSA Z314. 1.4.3 Climate change and sustainability This Standard provides high-level guidance to assess HCFs for sustainability, including operational continuity, environmental impact, energy management, reduction of GHG emissions that contribute to climate change, and increased resilience to the impacts of climate change. Assessments for these factors are embedded in the functional and technical assessments and referenced throughout this Standard. The outcome of assessment of space and systems for climate resilience and sustainability assessment could result in a recommendation for the development of a climate resiliency plan (CRP). A CRP is different than a business continuity plan. Note: For more information on business continuity/emergency management, see CSA Z8000 and CSA Z1600. 1.5 Terminology In this Standard, "shall" is used to express a requirement, i.e., a provision that the user is obliged to satisfy in order to comply with the Standard; "should" is used to express a recommendation or that which is advised but not required; and "may" is used to express an option or that which is permissible within the limits of the Standard. Notes accompanying clauses do not include requirements or alternative requirements; the purpose of a note accompanying a clause is to separate from the text explanatory or informative material. Notes to tables and figures are considered part of the table or figure and may be written as requirements. Annexes are designated normative (mandatory) or informative (non-mandatory) to define their application. 1.6 Units of measurement The values given in SI units are the units of record for the purposes of this Standard. The values given in parentheses are for information and comparison only. Note: Measurement of spaces in HCFs follow CSA Z8000 and CSA 317.11.