In the past two National Electrical Code (NEC) cycles, there have been substantial changes in Article 517 dealing with healthcare facilities. While there were some changes in the 2014 NEC, the majority of changes occurred in the 2017 NEC and are based on changes in NFPA 99, Health Care Facilities Code. Many of the changes in the NEC relate to definitions that ultimately shape the methods of dealing with healthcare and patients. Examining these definitions will give an insight into the direction for healthcare-related occupancies now and in the future.
One of the new definitions that applies to governing bodies (previously used in an informational note describing the authority for determining patient-care spaces but undefined) is “the person or persons who have the overall legal responsibility for the operation of a health care facility.” This definition now properly provides the designer and contractor with the entity responsible for the hospital, clinic or other healthcare facility.
Invasive procedure has a new definition (previously used in an informational note describing critical care spaces): “any procedure that penetrates the protective surfaces of a patient’s body (i.e., skin, mucous membrane, cornea) and that is performed with an aseptic field (procedural site). Not included in this category are placement of peripheral intravenous needles or catheters used to administer fluids and/or medications, gastrointestinal endoscopies (i.e., sigmoidoscopies), insertion of urethral catheters, and other similar procedures.”
This definition explains the difference between examining a patient in a doctor’s office and a procedure where the patient is being operated on or some other similar situation.
We finally have a clear, three-part definition of a medical (dental) office as “a building or part thereof in which the following occur: (1) examinations and minor treatments or procedures are performed under the continuous supervision of a medical or dental professional; (2) only sedation or local anesthesia is involved and treatment or procedures do not render the patient incapable of self-preservation under emergency conditions; and (3) overnight stays for patients or 24-hour operation are not provided.” Everyone seemed to know what a doctor’s office or dental office is, but we now have a clear statement in the NEC.
The above definitions are in Article 517. These next two paragraphs deal with how revisions of definitions will apply for now and the future of healthcare facilities. The primary definition of a healthcare facility has been expanded from “buildings and portions of buildings” to include mobile enclosures and then clarified that it only provides healthcare for humans: “Health Care Facilities” are “buildings, portions of buildings, or mobile enclosures in which human medical, dental, psychiatric, nursing, obstetrical, or surgical care are provided. Informational Note: Examples of health care facilities include, but are not limited to, hospitals, nursing homes, limited care facilities, clinics, medical and dental offices, and ambulatory care centers, whether permanent or movable.”
Again, the issue of mobile operating rooms, MRIs and similar mobile facilities has long been understood but now becomes official.
Selected receptacles has been revised as “a minimum number of receptacles selected by the governing body of a facility as necessary to provide essential patient care and facility services during loss of normal power.” This major revision directs this phrase toward only applying to essential receptacles supplied by the critical branch of a healthcare facility.
The phrase patient care spaces has been revised and expanded into four different categories. They are listed in this order. A patient care space is “any space of a health care facility wherein patients are intended to be examined or treated.”
A Category 3 space is a “basic care space in which failure of equipment or a system is not likely to cause injury to the patients, staff, or visitors but can cause patient discomfort.” This was formerly known as a basic care room, and is typically where basic medical or dental care, treatment or examinations are performed.
A Category 2 space is one “in which failure of equipment or system is likely to cause minor injury to patients, staff or visitors.” This was formerly known as a general care room and includes inpatient bedrooms, dialysis rooms, in-vitro fertilization rooms, procedural rooms and similar rooms.
A Category 1 space is one “in which failure or equipment or system is likely to cause major injury or death of patients, staff, or visitors,” such as operating rooms.
A Category 4 space is one “in which failure of equipment or a system is not likely to have a physical impact on patient care” and includes support rooms, such as waiting rooms, etc.
Be familiar with the new terms and phrases so you can deal with these new definitions and requirements.