Current through Register Vol. 48, No. 12, March 22, 2024
a)
Location
The freestanding emergency center shall be conveniently
accessible to the population served. In selecting location, consideration shall
be given to factors affecting source and quantity of patient load, including
highway systems, public transportation, industrial plants, and recreational
areas.
b) Parking
One parking space for each staff member on duty at any one time
and no fewer than two spaces for each major procedure room and each
observation/treatment room shall be provided. Handicapped parking spaces shall
be provided as required in the Illinois Accessibility Code. Additional spaces
shall be provided for emergency vehicles. Street, public, and shared lot spaces
shall be exclusive for the use of the emergency facility. All required parking
spaces shall be conveniently located to the emergency entrance.
c) Administration and Public Areas
1) The ambulance and walk-in entrance shall
be located at grade level and be able to accommodate wheelchairs.
A) All entrances shall be covered to permit
protected transfer of patients from ambulances, and a ramp for wheelchairs and
stretchers shall be provided in addition to steps. Doors to emergency services
shall be not less than 4 feet wide.
B) The emergency entrance shall have vision
panels to minimize conflict between incoming and outgoing traffic and to allow
for observation of the unloading area from the control station.
2) A lobby and waiting area shall
be provided and shall provide:
A) Convenient
access to wheelchairs and stretchers;
B) A control station that may be used for
triage functions, is in direct communication with medical staff and has direct
visual control of the emergency entrance, observation of arriving vehicles, and
access to treatment and lobby areas;
C) Waiting areas convenient to the reception
and interview areas;
D) Public
toilet facilities for males, females and/or families. Unisex toilet facilities
are prohibited.
3)
Facilities for conducting interviews with patients and others shall be provided
and shall include provisions for acoustical and visual privacy.
4) General and individual offices shall be
provided.
5) Clerical spaces shall
be provided.
6) Multipurpose rooms
for staff conferences and consultation shall be provided.
7) Equipment and general storage areas shall
be provided.
d) Clinical
Facilities
1) At least one major procedure
room shall be provided and shall meet the following requirements:
A) A minimum clear area of 360 square feet
exclusive of cabinets, shelves, door swings and fixed obstructions;
B) A minimum clear dimension of 16
feet;
C) Emergency communication
equipment connected to the nurses' control station;
D) X-ray film illuminator (as
necessary);
E) Mechanical and
electrical systems and devices that meet requirements for hospital surgical
rooms in the Hospital Licensing Requirements (77 Ill. Adm. Code 250).
2) Where additional procedure
rooms are set up for multi-patient use, these rooms shall meet the following
requirements:
A) A minimum clear area of not
less than 180 square feet per patient stretcher or bed;
B) A minimum clear dimension of 10 feet per
space;
C) Emergency communication
equipment connected to the nurses' control station;
D) X-ray film illuminator (as
necessary);
E) Mechanical and
electrical devices that meet requirements for hospital surgical rooms in 77
Ill. Adm. Code 250.
3) A
holding area for stretchers and wheelchairs within the clinical area shall be
provided and under staff control and located so as not to block means of
egress.
4) A poison control service
shall be provided that contains the following services:
A) Immediately accessible
antidotes;
B) A file of information
concerning common poisons; and
C)
Communications links with regional and national poison centers and regional EMS
centers.
5) A nurses'
work and control station shall be located to permit visual control and access
to clinical areas and shall contain space and equipment to allow the following
services to be provided:
A)
Charting;
B) Storage of
files;
C) Staff consultation;
and
D) Communication link with
examination/treatment, lobby and waiting area control, laboratory, radiology
and on-call staff.
6) A
cardiopulmonary resuscitation (CPR) emergency cart shall be located away from
traffic and available to all areas.
7) Scrub stations shall be provided at each
trauma/cardiac room with water and soap controls operable without the use of
hands.
e) Radiology
1) Facilities for basic diagnostic
radiological procedures shall be provided and shall include the following:
A) Space adequate to accommodate needed
equipment with a minimum clearance of 3 feet on all four sides of the
table;
B) A shielded control alcove
with windows providing a full view of the examination table and the patient;
and
C) A patient toilet accessible
from the radiology room.
2) Film processing facilities shall be
provided (if required).
3) Viewing
and administrative areas shall be provided.
4) Storage facilities for exposed film shall
be provided (if required).
5)
Dressing rooms or booths with convenient toilet access shall be
provided.
f) Laboratory
1) Laboratory facilities shall be provided
for the performance of tests in hematology, clinical chemistry, urinalysis,
microbiology, anatomic pathology and cytology to meet the work load.
2) Laboratory facilities shall provide for
the following procedures to be performed on-site: blood counts, urinalysis,
blood glucose, electrolytes, blood urea and nitrogen (BUN), coagulation, and
transfusions (type capability). If transport time by an ambulance to the
nearest hospital is 10 minutes or less, plasma expanders may be used. If
transport time by ambulance to the nearest hospital is greater than 10 minutes,
then type O negative blood shall be available for transfusion. Facilities shall
also be included for specimen collection and processing.
3) The following shall be provided in the
laboratory suite:
A) Work counters with space
for items such as microscopes, chemical analyzers, incubators and centrifuges;
work counters shall include sinks and provisions for fluid disposal, eye
washes, vacuum, gases, electrical services and piped-in air;
B) Hand-washing lavatories operable without
the use of hands at strategic locations for convenience of use;
C) Storage facilities;
D) Chemical safety provisions, including
emergency showers, eye-flushing devices and blankets; floor drains at the
emergency shower locations;
E)
Flammable liquid storage in the form of vented cabinets designed for use with
flammable liquids;
F) Specimen
collection facilities including: blood collection area with work counter; space
for patient seating and hand washing; a urine and feces collection room
equipped with water and lavatory;
G) A terminal sterilization facility for
contaminated specimens (autoclave or electric oven), unless contaminated waste
is disposed of through a licensed waste management service in accordance with
Section
518.2150(f)(4);
and
H) If radioactive materials are
employed, facilities for long-term storage and disposal of these materials,
appropriately shielded to prevent exposure.
g) Staff locker rooms and toilets shall be
provided.
h) At least one
housekeeping room per floor shall be provided. The housekeeping room shall
contain a service sink and storage for housekeeping supplies and equipment and
shall be located within the FEC.
i)
Utility Rooms
1) A clean utility room shall
be provided and contain the following:
A)
Storage for clean and sterile supplies and equipment;
B) Work counters;
C) Hand-washing sinks operable without the
use of hands;
D) Ice
maker;
E) Under-counter
refrigerator; and
F) Communications
equipment.
2) A soiled
utility room shall be provided and contain the following:
A) Storage for soiled supplies and
equipment;
B) Work
counters;
C) Hands-free
hand-washing sinks;
D)
Communications equipment; and
E)
Clinical service sink.
j) Sterile supply and processing rooms shall
be provided and may be combined with the clean and soiled utility rooms if the
program narrative is approved.
1) One-way
flow shall be maintained between the soiled supplies, clean-up, sterilizing,
and storage functions.
2) Storage
spaces for clean and sterile supplies and equipment shall be
provided.
3) Storage spaces for
soiled supplies and equipment shall be provided.
4) There shall be no direct access between
the soiled and clean sides of sterile supply and processing.
5) Work counters and hand-washing sinks
operable without the use of hands shall be provided.
6) A clinical service sink shall be provided
on the soiled side.
7) The soiled
side shall have equipment for cleaning, such as ultrasound, washers, and deep
three-compartment sink and tray assembly.
8) A pass-through sterilizer shall be
provided.
9) Space shall be
provided in the soiled side for processing equipment and tray assembly, such as
steris machines, dryers, tube racks, wrapping and labelling counters. The
steris machine shall be located in a clean utility room. Only tray loading is
permitted in the soiled side.
k) A nourishment room for the use of
patients, conveniently located to the clinical area, shall contain the
following:
1) Work counter;
2) Refrigerator;
3) Ice maker;
4) Hands-free hand-washing sink;
and
5) Storage for
supplies.
l) Facilities
shall be provided for observing patients until they can be transferred to an
appropriate hospital. The size and type of equipment shall be what is required
for anticipated patient load and lengths of stay. Each observation bed shall
provide for:
1) Direct visual observation of
each patient from the nurses' station;
2) Patient privacy;
3) Access to patient toilets;
4) Secure storage of patients'
belongings;
5) Medication
dispensing;
6) Bedpan storage and
cleaning;
7) Hand-washing
facilities without the use of hands;
8) Communications system with nurses station;
and
9) Monitoring
capabilities.
m) A
consultation/communications room shall be located within access of the
diagnostic and treatment facilities and shall provide sound isolated for
privacy and confidentiality of consultation for the use of the staff during the
tele-medicine consultation. The room shall contain the following:
1) Computer support and telecommunications
support equipment necessary for the consultation task;
2) View screens;
3) Work counters;
4) Storage areas; and
5) Additional refrigeration units as required
by equipment.