Magazine article Health Facilities Management

ADA-Ready: Ten Steps to Ensuring Hospital Accessibility Compliance

Magazine article Health Facilities Management

ADA-Ready: Ten Steps to Ensuring Hospital Accessibility Compliance

Article excerpt

Most health facilities professionals are confident that their hospitals and equipment are accessible. However, there is growing evidence that persons with disabilities may receive inequitable care due to lack of accessible facilities, equipment, information and accommodations.

Staff members also are extremely busy and typically not trained to recognize a disability or the appropriate protocols for responding. Even when they do, they often do not have the time to walk over to a person who is deaf to signal their appointment, the strength to lift a patient or the hierarchical status to ask a doctor to switch exam rooms to make an accessible room available for another doctor's patient.

Health facilities professionals can play a significant role by ensuring equal access to health care for those with disabilities and mitigating any shortcomings during hospital construction and renovation projects.

Taking proactive steps

An Americans with Disabilities Act (ADA) compliance initiative requires comprehensive, top-down management attention. Facilities professionals can play a significant role in its success by following 10 steps to ensure full access to newly constructed and altered health care facilities.

1. Project scoping. When defining an alterations project, facilities professionals should be sure to include barrier removal along the entire path of travel from sidewalks and parking to the area that is being altered. This includes parking, drop-off, entrance, protruding objects along corridors, toilet rooms, signage and alarms. Known as the "ADA Path of Travel" requirement, it applies to most employee as well as public areas.

2. Request for proposal (RFP) and contract language for designers. The RFPs and contracts for design services should itemize compliance with the 2010 ADA Standards for Accessible Design as the designer's responsibility, separate from and in addition to building code conformance. Although the two are often similar, they are not the same. Not only are there technical and jurisdictional differences, the ADA standards are enforced as civil rights violations and the building code as a safety standard. It is not appropriate to ask designers to "comply with the ADA" because the ADA addresses much more than design and construction. However, designers can be expected to use the correct ADA design standard.

3. RFP and contract language for contractors. The RFPs and contracts for construction services also should itemize compliance with the 2010 ADA Standards for Accessible Design as the contractor's responsibility, separate from and in addition to building code conformance. All too often, facilities are designed correctly, but contractors are still constructing to the standards they have used for generations. As a result, correctly designed toilet rooms appear accessible and are constructed with tolerances that historically may have been acceptable, but no longer meet minimum standards. Problems include toilets too far from the wall, grab bars located in less functional places and deep sinks that constrict knee space underneath. These are common construction errors that create functional difficulties and can be very costly to correct.

4. Accessible design review protocols. Health facilities professionals regularly review design plans. However, there are key decisions in different pilases of design that affect ADA compliance and accessibility. For example, the location of accessible parking and drop-off areas --including adequate vertical height for high-top vans--is critical at the earliest phase of garage design. In allocating clinic space, it is important to allow enough space for accessible exam rooms that will accommodate larger equipment and the additional maneuvering space required around it for the patient and staff. It is difficult to enlarge these rooms in later phases without compromising other programmatic needs. Project managers should be aware of the equipment that is being ordered for these areas. …

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