History of the Guidelines

The FGI Guidelines for Design and Construction 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 regulatory 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. An agreement was finally reached 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 the multidisciplinary HGRC came from the federal and state governments and the private sector. They offered expertise in design, operation, and construction of health care 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 make sure the document would be kept current, FGI was formed in 1998 with a four-member board of directors. The board has grown over time and now includes eight members with a wide range of expertise.

FGI’s main objective remains seeing that the FGI Guidelines documents are reviewed and revised on a regular cycle with a consensus process by a multidisciplinary group of experts from the federal, state, and private sectors.

(A more detailed history of the Guidelines is in each published document.)

FGI is committed to finding the best people from a variety of professions to debate and discuss setting minimum standards with the goal of reaching consensus on what is fundamental to the development of safe, effective care environments. We collaborate with other standard-setting organizations in the health care design industry and utilize the best available research. All of this collaboration enhances the credibility of the Guidelines and our work as an organization.
Joe Sprague, FAIA, FACHA, FHFI, HKS Architects

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