FGI Bulletin #12

FGI Releases Second Edition PHAMA White Paper

Provides new guidance on patient handling and mobility

FGI is thrilled to announce the release of the second edition of the Patient Handling and Mobility Assessments (PHAMA) white paper, made available for download free of charge with the generous support of Hillrom, an FGI Keystone Partner.

Interest in the area of safe patient handling and mobility (SPHM) has grown remarkably since the PHAMA white paper was first published nine years ago. In recognition of that, the second edition provides updated information about requirements in the 2018 FGI Guidelines documents that support SPHM practices and provides tools to help designers and health and residential care organizations design and implement SPHM programs that meet the needs of patients and staff.

Mary W. Matz, MSPH, CPE, CSPHP, a primary author of the first edition white paper, is the principal author of the second edition. She is a board-certified ergonomist experienced in SPHM technology and design requirements, program implementation, maintenance, and cost-benefit analysis. She spent more than 15 years developing, implementing, and overseeing the Veterans Health Administration’s national SPHM program. Mary also is a co-presenter with Joseph J. Strauss, AIA, ACHA, for FGI’s on-demand webinar “Accommodations for Care of Patients of Size,” available on FGI’s YouTube channel. 

“Through the second edition of the PHAMA white paper, design professionals are guided to incorporate design criteria that facilitate critical aspects of current care [such as] fostering patient and resident mobilization and safe care of individuals of size,” Mary explains. “Increasingly, bodies of evidence point toward mobilization as the single most important method to impact patient outcomes, such as reducing the number of [health care-associated] infections and patients’ length of stay in the hospital, as well as shortening time needed for rehabilitation. Such essential mobilization depends on the use of patient handling technology that is determined through the use of a patient handling and mobility assessment.”

Download Proposed Interim Amendment to the 2018 Residential Guidelines

Comment period is open for two weeks—don’t wait!

Since publication of the 2018 edition of the Guidelines for Design and Construction of Residential Health, Care and Support Facilities, FGI has received requests from several state authorities having jurisdiction (AHJs) asking for minimum square footages for resident rooms in nursing homes.

These AHJs are unwilling to adopt Chapter 3.1, “Specific Requirements for Nursing Homes,” in the 2018 Residential Guidelines because it lacks requirements for a minimum clear floor area. Although clearances are recommended in Section 3.1-2.2.2 (Resident Room), location of these dimensions in the appendix means they cannot be enforced by an AHJ.

In response to this issue, the Residential Document Group (RDG) of the Health Guidelines Revision Committee (HGRC) has drafted text with prescriptive language for room sizing. The RDG has proposed this revised text for the 2022 Residential Guidelines document, but—to address the enforcement issue in a more timely fashion—the group has also requested it be considered as an interim amendment to the 2018 Residential Guidelines. After a period for public comment followed by review by the HGRC Steering Committee, it will be considered an official part of the 2018 Residential Guidelines if the Steering Committee approves the language.

Comments are invited from the public and the Health Guidelines Revision Committee on the proposed changes to the 2018 Residential Guidelines text, which can be downloaded from the FGI website HERE. Please email your support or objection, with details if necessary, here.

The comment period will be from noon on Thursday, October 17, 2019, through noon Eastern on Friday, November 1, 2019.

Guidelines Errors and Corrections: Updated Errata Sheets Available

FGI periodically issues updated errata sheets for all of the Guidelines documents as errors are found and corrected. At the request of a couple of authorities having jurisdiction, new errata sheets for the 2018 Guidelines show the date each erratum was originally published.

Because these corrections are enforceable as part of the text in most adopting jurisdictions, it is important that all Guidelines users have an understanding of where to access the most current errata sheets. Current errata sheets can be found on this page of the FGI website. If you are a subscriber to the 2018 edition through MADCAD, you can also access the errata sheets here: As shown in yellow below, MADCAD also alerts you that an erratum exists when you are in a section with a correction:

Still Need CEUs for 2019?

Don’t forget that FGI has a series of 10 webinars on the 2018 Guidelines documents available on demand through MADCAD. Each webinar is an hour in length, presented by members of the Health Guidelines Revision Committee, and approved by the American Institute of Architects for Health, Safety, Welfare CEUs. Members of other organizations are eligible to receive a certificate of attendance for use toward professional certifications.

The Guidelines topics covered by the webinars are:

• 2018 Guidelines Update: Changes to Keep Pace with Clinical Practices
• Appropriate Room Use—Part 1: Exam, Procedure, and Operating Rooms
• Appropriate Room Use—Part 2: Imaging Room Classifications
• Flexible Application of the Outpatient Guidelines
• Accommodations for Care of Patients of Size
• Pod People: Low-Acuity Patient Treatment Stations in the ED
• Breaking Bad: Improving Resident-Centered Regulations
• Sterile Processing Department: Design and HVAC Considerations
• The Functional Program and Safety Risk Assessment: How to Create and Apply Them
• Use of the Guidelines for Design and Construction: An Architect’s, an Owner’s, and an AHJ’s Perspective

FGI’s 2018 webinars are now available free of charge on FGI’s YouTube channel.

Guidelines Adoption Update

The FGI adoption map provides the most current information FGI has about state use of the Guidelines documents. The data we have can be summarized as follows:

• As of October 17, 2019, 19 states and the District of Columbia have adopted the 2018 edition.
• 39 states have adopted some edition of the Guidelines (this includes Wisconsin, which has adopted only the HVAC requirements).
• 6 states (Colorado, Idaho, Kansas, Maine, Mississippi, New York) have adopted editions prior to the 2018 Guidelines but permit use of a more recent edition in some instances.
• 4 states do not adopt but allow use of the Guidelines as an alternate path to compliance in some instances.
• 7 states do not use the Guidelines in any official capacity, although most of these appear to use the documents for reference.