This is the first edition of the Guidelines in which requirements for hospitals, outpatient facilities, and residential care facilities are presented in three independent documents. Facility types covered in the 2018 Guidelines for Design and Construction of Hospitals include general hospitals, freestanding emergency care facilities, critical access hospitals, psychiatric hospitals, rehabilitation hospitals, children’s hospitals, and mobile/transportable medical units.

Changes in the 2018 Hospital Guidelines include a new section on accommodations for care of patients of size; addition of an option for flexibility by combining pre- and post-procedure patient care areas; and a complete overhaul of imaging requirements. Other notable updates address telemedicine spaces, acoustic design, airborne infection isolation rooms, sterile processing facilities, and mobile/transportable units.

As with the previous two editions, ANSI/ASHRAE/ASHE Standard 170: Ventilation of Health Care Facilities was incorporated into the Guidelines to provide ventilation requirements for health care facilities. The 2018 edition of the Guidelines for Design and Construction of Hospitals includes the 2017 edition of ASHRAE 170, with all addenda approved through November 2017.

This is the first edition of the Guidelines in which requirements for outpatient facilities are presented independently from hospital and residential care facility requirements. Facility types covered in the 2018 Guidelines for Design and Construction of Outpatient Facilities include general and specialty medical services facilities, outpatient imaging facilities, birth centers, urgent care centers, infusion centers, outpatient surgery facilities, freestanding emergency care facilities, endoscopy facilities, renal dialysis centers, outpatient psychiatric centers, outpatient rehabilitation therapy facilities, mobile/transportable medical units, and dental facilities.

Changes in the 2018 Outpatient Guidelines provide guidance on two approaches for applying the Guidelines requirements to outpatient facility projects; a new section on accommodations for care of patients of size; a classification system for imaging rooms; and expanded laboratory, new pharmacy, and revised sterile processing facility requirements.

As with the previous two editions, ANSI/ASHRAE/ASHE Standard 170: Ventilation of Health Care Facilities was incorporated into the Guidelines to provide ventilation requirements for health care facilities. The 2018 edition of the Guidelines for Design and Construction of Hospitals includes the 2017 edition of ASHRAE 170, with all addenda approved through November 2017.

The 2018 edition of the Guidelines for Design and Construction of Residential Health, Care, and Support Facilities restructured the previous edition for clarity, and—based on needs in the residential long-term care marketplace—guidance for additional facility types was added. As with the previous edition, the document covers nursing homes, hospice facilities, assisted living facilities, independent living settings, adult day care and adult day health care facilities, wellness centers, and outpatient rehabilitation therapy facilities.

This edition continues moving away from institutional models to foster development of person-centered living environments that support a variety of care models and add to quality of life for residents. The goal is to help care organizations and designers create homelike physical environments that support positive resident outcomes. Included are a new section on post-acute care facilities and new chapters on substance abuse treatment facilities and settings for individuals with intellectual and/or developmental disabilities.