A Word from the President about FGI

"The Facility Guidelines Institute (FGI), a not-for-profit corporation, was founded in 1998 to provide continuity in the facility guidelines revision process, function as a contractual coordinating entity, and enhance the content and format of guidelines publications that encourage and improve their application and use. The Board of Directors reports that FGI has exceeded expectations in every respect as we finalize the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities and introduce the new 2014 Guidelines for Design and Construction of Residential Health, Care, and Support Facilities."

The History of FGI

The Guidelines for Design and Construction Health Care Facilities has a long history as a federal and privately written document. The original General Standards appeared in the Federal Register on February 14, 1947, as part of implementing regulations for the Hill-Burton program. The standards were revised from time to time as needed. In 1974 the document was retitled Minimum Requirements of Construction and Equipment for Hospital and Medical Facilities to emphasize that the requirements were generally minimum, rather than recommendations of ideal standards.

In 1984 the Department of Health and Human Services (DHHS) removed from regulation the requirements relating to minimum standards of construction, renovation, and equipment of hospitals and medical facilities, as cited in the Minimum Requirements DHEW Publication No. (HRA) 81-14500. Since the federal grant and loan programs had expired, the federal government had no need to retain the guidelines in regulation format. At this time, DHHS asked the American Institute of Architects Committee on Architecture for Health (AIA/CAH) to form an advisory group to work with, and be funded by, the Public Health Service for the next revision. When the revisions were complete, the federal government declined to publish the document. The AIA/CAH asked several nonprofit agencies and professional associations to publish and distribute the Guidelines. They finally reached an agreement with the American Institute of Architects to publish the 1987 edition. At this point, revision of the Guidelines would have ended, or the document would have ceased to exist, if three people had not taken it upon themselves to approach the Public Health Service and the Health Care Financing Administration to request a federal grant to fund a revision cycle. These same three people, working with AIA/CAH, put together the first Steering Committee, who in turn set up the first Health Guidelines Revision Committee (HGRC) not under the aegis of the federal government. The members of this multidisciplinary group came from the federal and state governments and the private sector and offered expertise in design, operation, and construction of health facilities. The 1992-93 edition of the Guidelines was published and distributed by the AIA.

In an effort to create a more formal procedure and process, and to ensure the document is kept current, the Facility Guidelines Institute (FGI) was formed in 1998 with a four-member board of directors (the original three people who kept the document alive plus a Steering Committee member). This board has grown over time and now includes eight members with a wide range of expertise. The main objective and thrust of FGI is to see that the Guidelines document is reviewed and revised on a regular cycle with a consensus process by a multidisciplinary group of experts from the federal, state, and private sectors. FGI serves as the contracting agent for the work performed by the HGRC and by the publisher of the document.

FGI and the HGRC

FGI is primarily interested in consensus methodology and in having the responsibility for overseeing the revision process. Specifically, FGI wants to make sure the Health Guidelines Revision Committee:

  • Is properly funded.
  • Has a balance of representation from interest groups with expertise or jurisdiction.
  • Uses the consensus process.
  • Requests public input in the form of proposals for change and comments on proposed changes.
  • Reviews and revises the Guidelines on a timely basis to maintain a balance between a minimum standard and the state of the art in health care design and construction.
  • Operates under a formal set of bylaws governing its purpose, scope, membership, and goals to include information regarding “Duties and Responsibilities" and “Appointments, Terms and Officers."

FGI and the Public

FGI acts as the day-to-day contact with the public to monitor requests for interpretations. Our goals are to make sure that requests are answered in a timely manner, that interpretations are rendered by those individuals best equipped to reflect the intent of the HGRC when the document was written, and that interpretations are made public. FGI also acts as the agent to disperse funding for research and development projects requested by the HGRC Steering Committee.

FGI is dedicated to:

  • Encouraging and sponsoring research projects to support the evidence-based decision-making process.
  • Improving the process to allow more time to study and evaluate proposals for changes and to comment on changes.
  • Improving the format, readability, and indexing or searchability of the document to make it a more useful and user-friendly tool.
  • Improving the HGRC’s ability to communicate and receive information electronically, making full use of the Internet and other formats and programs as they become available. This includes requests for interpretation, white papers, etc.
  • Working constantly to improve the process and the content of the Guidelines to keep it a dynamic document that truly reflects the latest state of the art.
  • Continuing to strive for a document that is credible, reasonable, and knowledge-based and that will maintain the tradition of the American hospital as the role model for the rest of the world.