specialty doors for healthcare design

of 69 ©2021 ∙ Table of Contents

About the Instructor About the Sponsor Ask an Expert

This Online Learning Seminar is available through a

professional courtesy provided by:

AMBICO Limited1120 Cummings Avenue

Ottawa, ON K1J 7R8

Tel: 613-746-4663

Fax: 613-746-4721

Toll-Free: 1-888-423-2224

Email: [email protected]

Web: www.ambico.com

powered by

©2021 Company Name. The material contained in this course was researched, assembled, and produced by Company Name and remains its

property. Questions or concerns about the content of this course should be directed to the program instructor. This multimedia product is the

copyright of AEC Daily.

Specialty Doors for Healthcare Design

mailto:[email protected]

http://www.ambico.com/

https://www.aecdaily.com/




To ensure the current status of this course, including relevant association approvals, please view the course details here.


The American Institute of Architects

Course No. AEC1359

This program qualifies for 1.0 LU/HSW Hour

Course Expiry Date: 12/17/2022

AEC Daily Corporation is a registered provider of AIA-approved continuing education under Provider Number J624. All registered AIA CES

Providers must comply with the AIA Standards for Continuing Education Programs. Any questions or concerns about this provider or this

learning program may be sent to AIA CES ([email protected] or (800) AIA 3837, Option 3).

This learning program is registered with AIA CES for continuing professional education. As such, it does not include content that may be

deemed or construed to be an approval or endorsement by the AIA of any material of construction or any method or manner of handling, using,

distributing, or dealing in any material or product.

AIA continuing education credit has been reviewed and approved by AIA CES. Learners must complete the entire learning program to receive

continuing education credit. AIA continuing education Learning Units earned upon completion of this course will be reported to AIA CES for AIA

members. Certificates of Completion for both AIA members and non-AIA members are available upon completion of the test.

https://www.aecdaily.com/faculty_bio.php?parent_id=2024882

https://www.aecdaily.com/sc.php?node_id=1465744&tabidx=corporate

https://www.aecdaily.com/forums.php?node_id=2024882

https://www.aecdaily.com/course.php?node_id=2024882&tabidx=viewcoursedetails

mailto:[email protected]



This course is approved by GBCI for

continuing education. Approval for this

course indicates it will be monitored by GBCI

to ensure that it upholds the quality,

relevance and rigor necessary to contribute

to ongoing learning in knowledge areas

relevant to the green building industry.

Approved for:

1.0 CE hour

Course is approved for:

LEED Specific (BD+C, ID+C, Green Associate) and WELL Specific

Approval date:

September 3, 2021

Course title:


Course ID:

0920024665






AEC Daily Corporation has met the standards and requirements of the Registered

Continuing Education Program. Credit earned on completion of this program will be

reported to RCEP at RCEP.net. A certificate of completion will be issued to each

participant. As such, it does not include content that may be deemed or construed to be

an approval or endorsement by the RCEP.






To print or exit the course at any time, press the ESC key on your keyboard. This will minimize the full-screen

presentation and display the menu bar.

Within this course is a test password that you will be required to enter in order to proceed with the online test.

Please be sure to remember or write down this test password so that you have it available for the test.

To receive a certificate indicating course completion, refer to the instructions at the end of the course.

For additional information and postseminar assistance, click on any of the logos and icons within a page or any of the

links at the top of each page.

How to Use This Online Learning Course






Purpose:

Specialty door and frame assemblies have been developed that are designed specifically for the built healthcare

environment where performance criteria are critical. Reviewed in this course are specialty door and frame assemblies

that meet the challenges of infection prevention, building cleanliness, patient privacy, and increased security, as well as

containment of radio wave and radiation interference in hospitals and clinics.

Learning Objectives:

At the end of this program, participants will be able to:

• state the important attributes of a specialty door and frame assembly in healthcare facilities and summarize the

benefits of using stainless steel doors and frames in healthcare design

• list the key components of acoustic doors and how they meet the requirements of the WELL Building Standard™ and

LEED® v4 BD+C and ID+C

• define the need for and role of specialty assemblies designed for security (bullet resistant and antibarricade) in

healthcare facilities, and

• summarize the basic requirements, standards, and testing for fire-rated door assemblies.

Purpose and Learning Objectives






Specialty Doors: Healthcare Design Considerations

Stainless Steel

Specialty: Acoustic Doors

Specialty: Bullet-Resistant Doors / Security Doors

Specialty: Radiation Shielding / Radio Frequency Attenuating

Fire-Rated Assemblies

Summary

Contents






Specialty Doors: Healthcare Design Considerations






Introduction

Healthcare door and frame assemblies tend to

have need for multiple functions, such as fire

ratings, acoustic requirements, bullet resistance

requirements, or radiation/radio frequency

attenuation requirements. For behavioral health

applications, special antibarricade security

wood doors may be essential in patient rooms

for safety.

In this course, we will look at these specialty

opening functions separately with the

understanding that in some situations, some or

all of these functions may be combined.

This section of the course begins with a review

of the important attributes of specialty door and

frame assemblies that must be considered in

healthcare facility design.






Incidences of healthcare acquired infections (HAIs) are high in most countries and are a major concern to the

healthcare industry. In American hospitals alone, the Centers for Disease Control (CDC) estimates that HAIs account for

roughly 1.7 million infections and 99,000 associated deaths each year. Occurring in all settings of healthcare—including

hospitals, surgical units, ambulatory clinics, and long-term care facilities—HAIs are a significant, but often preventable,

threat to patient safety. Studies have shown that most HAIs are passed on by hand-borne transmission.

Doors can sometimes be an afterthought during the design process. However, they are an object that is touched

frequently and used by everyone (staff, patients, visitors, etc.) throughout a healthcare facility. In critical control areas

where patients are at an increased risk of infection—such as operating rooms, intensive care units, delivery rooms, burn

units, etc.,—selecting the right door is crucial to infection prevention. It is important to specify doors that maximize

hygiene, safety, and efficiency in the most demanding healthcare environments.

Hygienic Properties






Durability / Reputable Manufacturer / Sustainability

Doors in today’s healthcare facilities have to endure heavy usage. As a result, they must be

durable and offer longevity combined with ease of cleaning with a minimum of

maintenance. Furthermore, with sustainability at the forefront of the healthcare industry,

door and frame assemblies that require frequent servicing or restoration should be avoided.

When sourcing specialty door and frame assemblies, seek a reputable manufacturer who

offers outstanding customer service and support with a wide sales and distribution network.

It is vital that potential manufacturers fully understand the specific needs and preferences

of the healthcare facility so they can advise of their product offerings and provide all of the

information required to make an informed decision. It is also important to source products

from manufacturers who have adopted sustainable principles and practices, including

manufacturing processes that minimize production and processing wastes.






Another very important consideration when selecting doors for healthcare applications is the material type. How does

the material fare in terms of the aforementioned design considerations (hygienic properties, durability, sustainability)?

Doors may be made of a variety of materials, including wood, aluminum, stainless steel, and fiberglass.

For the purposes of this course, we will review assemblies for specialty steel doors, specialty stainless steel doors, and

specialty wood doors.

Before that, however, we will discuss the attributes of stainless steel and how it combines with state-of-the-art

technologies to meet the stringent demands of specialty healthcare applications.

Material Type






Stainless Steel

Lead-Lined Door & Frame Stainless Steel Door & Frame Acoustic Door & Frame






Stainless Steel: Introduction

Stainless steel is defined as a series of steel alloys that include at least 10% chromium, with or without other alloying elements. It is this chromium composition that gives stainless steel its exceptional corrosion resistance.

Dozens of stainless steel alloys exist. By far, the most common alloy used in door production is Type 304, which is composed of 18% chromium and 8% nickel.

Due to its many favorable attributes, stainless steel is used widely for items in a variety of markets, including healthcare, automotive, and food/beverage.






Stainless steel is easily maintained and it retains its strength at high temperatures. In fact, compared to wood,

aluminum, and fiberglass, only stainless steel offers a three-hour fire rating.

Stainless steel offers ease of fabrication, meaning it can be cut, welded, formed, and machined as readily as traditional

steels.

Impact resistance is another benefit of stainless steel. The austenitic microstructure of the 300 series provides

toughness and durability, from elevated temperatures to far below freezing, making these steels suited to cryogenic

applications.

The easy cleaning ability of stainless makes it the first choice for strict hygiene conditions, such as hospitals, kitchens,

and food processing plants.

Stainless steel offers design and function versatility. Available in a variety of grades and finishes, stainless steel

provides a range of aesthetics to meet particular design requirements.

Benefits of Stainless Steel






Recyclability

Stainless steel’s recyclability and durability are the key properties that make it a sustainable

material that is ideally suited for green design in healthcare facilities.

Both the U.S. and Canadian Green Building Councils recognize the environmental benefits of

using high-recycled-content materials. Stainless steel is 100% recyclable and can be

continuously recycled with no loss of performance.

The metal’s high scrap value combined with its recyclability ensures that it is diverted from

landfills and recaptured for use in new stainless steel. In fact, a study by the International

Stainless Steel Forum (ISSF) determined that roughly 92% of the stainless steel utilized in

architecture, building, and construction applications is recaptured and recycled at the end of

service.*

*Source: http://www.ssina.com/sustainability/#rcont




http://www.ssina.com/sustainability/#rcont



Durability

Stainless steel is durable and offers a long service life.

Due to their long-term durability, steel frames are often used in patient rooms. A

frame that is durable will likely not get damaged and will eliminate costly wall

repairs. For example, illustrated here is a hospital stop profile and sanitary base.

A hospital stop is sloped at a 45° or 90° angle to allow gurneys and carts to slide

through the frame without getting the wheels caught on the stop.

A sanitary base is a modification to a door frame where the stop is terminated

above the floor, typically at 4″ or 6″ from the bottom of the frame. A sanitary base

makes it easier to clean and mop at the frame sills because there are no extra

corners to catch debris.

Hospital Stop Profile

Double Rabbet Profile with

Sanitary Base






Hygienic Properties

Wood, aluminum, and fiberglass are porous materials and are

more difficult to sanitize than stainless steel.

Stainless steel is well suited to applications requiring high

levels of cleanliness as it has antimicrobial properties, it is

corrosion resistant, and it washes easily when an appropriate

finish is specified. Additionally, stainless steel can be cleaned

with a variety of chemicals without oxidation.

Stainless steel doors are available with weld seam “seamless”

edges and flush vision lite kits designed specifically to meet the

stringent needs of hygienic areas within healthcare facilities.






Finishes

Stainless steel is available in a variety of finishes, ranging from mill or 2B, to satin #4, #6, XL Blend S, and polished #8

and #10.

• Satin finish (#4) is the most common, used in a wide variety of architectural and manufacturing environments.

• Mirror finishes (#8 and #10) are used when an outstanding polished finish is the primary objective.

Grades

Stainless steel doors can be custom designed and produced in a range of alloys that vary in corrosion resistance. The

two most common types are Type 304 and Type 316.

• Type 304 is the most commonly specified alloy, accounting for more than half of the stainless steel produced in the

world. 304 can withstand corrosion from most oxidizing acids, but it is susceptible to corrosion from chloride

solutions, or from saline environments (e.g., coastal applications).

• Type 316, the second-most common form of stainless steel, has a similar makeup to 304. The key difference is that

316 contains 2%–3% molybdenum (304 has none), which gives a greater resistance to corrosion, particularly against

chlorides and industrial solvents.

Finishes / Grades




Review Question

What are the important attributes of specialty door and

frame assemblies that must be considered in healthcare

facility design?

Answer

What are the important attributes of specialty door and

frame assemblies that must be considered in healthcare

facility design?

Important attributes include:

• Hygienic properties

• Durability/longevity

• Ease of cleaning/minimum maintenance

• Sustainability

• Reputable manufacturer

• Material type



Specialty: Acoustic Doors






Specialty Doors: Acoustic: Introduction

Sound control is an issue that needs to be addressed in the design of any building. It is

important to ensure that the acoustic environment of the building is compatible with the

general needs and comfort of the occupants.

For healthcare environments, acoustic door and frame assemblies abate the

disquieting noise inherent in most healthcare facilities.

Acoustic assemblies have been developed that not only satisfy sound attenuation

requirements, but also help to meet LEED credit rating criteria and green design goals.

These acoustic door and frame products are designed to meet a wide range of STC

standards.

The specialty door industry offers a range of acoustic window and door products.






When an acoustic opening is required, the current CSI standard specification (Section 08 34 74) requires the supply of a

complete, independently tested acoustic assembly including the frame, door(s), and all seal and optional components.

As the demand for acoustic security becomes widespread in commercial and institutional construction, the standardized

acoustic performance of doors and frames, complete with integrated acoustic lites, has become essential.

The term acoustic assembly has specific meaning and indicates that the door leaf, door frame, perimeter and bottom

seals, and acoustic glazing are to be supplied as a complete assembly just as they were tested in an independent

laboratory.

It is important to understand that where STC ratings are called for, the smallest alteration to a tested acoustic assembly

can have significant negative effects on the performance levels of acoustic door and frame assemblies. Consequently,

great care must be taken not only to specify laboratory tested door and frame assemblies, but also to ensure that these

assemblies are installed in complete accord with the manufacturer’s instructions.

Acoustic Assemblies Defined






STC Ratings

Under ASTM E90, ASTM E413, ASTM E336, and ASTM E2964 a

product is given an STC rating, which is an average of its acoustic

performance across 18 different sound frequencies ranging from 125

Hz to 4000 Hz. The calculation is a function of the test standard and

is executed by the testing lab.

At right is an illustration of an STC contour chart showing the

performance of a typical acoustic door and frame assembly at the

STC 52 level.

The Y axis indicates the extent of noise, measured in decibels,

stopped by the assembly at each frequency. You will notice that the

STC contour is not flat, i.e., it attenuates less sound at low-range

frequencies than it does at the high-range frequencies.

Performance of Typical Acoustic Door at STC 52 Level






ADA Requirements

Acoustic door and frame assemblies that comply with

accessibility codes—specifically ASTM A117.1—are available

in the market.

These acoustic assemblies have been tested with a range of

hardware preparations, such as surface vertical rod or

concealed vertical rod exit devices and flat thresholds.

Engineered applications may be available for continuous

hinges, pivots, and concealed closers. These doors must also

include level swing applications, light door panels, and robust

seal systems.

Acoustic door panels with superior STC ratings have been

designed in standard 1 ¾″ thicknesses weighing between 7

pounds per square foot and 10 pounds per square foot.

Custom door bottoms have been designed to complement

these assemblies, enabling the use of level swing doors with

heavyweight butt hinges.






Acoustic Doors & LEED

Steel or wood door materials can meet LEED credit rating criteria on request.

Additionally, specialty doors can meet the WELL Building Standard for Comfort requirements

(acoustic comfort and ADA accessible design standards).

As well, wood door materials can also meet Forest Stewardship Council® (FSC ®) standards.

These acoustic assemblies utilize wood door panels where less than 10% of the product is

obtained from the forest. The panels consist of laminated FSC-CoC (Forest Stewardship

Council Certification, Chain-of-Custody) wood veneers with matching solid wood stiles and

rails. Combined with an acoustic door core, these wood door products provide a recycled

content of over 50%.






LEED v4 EQ Credit: Acoustic Performance






• Assembly

• Frame

• Door(s) in either steel or wood and plastic laminate veneer

• Acoustic perimeter seals

• Door bottom(s)

• Threshold

• Options

• Vision lite kit(s) and glazing

• Astragal (at pairs)

• Cam lift hinges (when required)

• Fire labels

A review of the assemblies is presented in subsequent slides, beginning with door and frame assemblies.

Components of an Acoustic Assembly






Acoustic Steel Door & Frame

Acoustic steel door and frame assemblies are provided complete with

acoustic steel frames, and perimeter and bottom seals. They combine

excellent sound transmission loss with the appearance of a standard

hollow metal product. Soundproof steel doors are available in a range of

thicknesses and STC ratings.

• 1 ¾″ (44 mm) thick - STC 33 to STC 53

• Greater thicknesses - STC 54 to STC 64

Options include factory preinstalled acoustic glazing up to STC 54 and

acoustic borrowed lites that achieve up to STC 56.

Fire labeled products have been tested in accordance with NFPA 80 and

are supplied in singles or pairs with fire ratings up to three hours.

Acoustic Steel Doors and Frame

Performance Rating: STC 52






Acoustic Wood Veneer Door & Steel Frame

In an acoustic wood door and steel frame assembly, an acoustic core forms

the substrate of the door leaf. Consequently, the acoustic steel core

construction of the wood-clad door blocks sound and performs at the STC

levels of many steel doors. The result is the pleasing aesthetics of a wood

door that is often preferred in the healthcare marketplace, combined with the

rugged durability of a steel door.

• 1 ¾″ (44 mm) thick - STC 33 to STC 50

• Greater thicknesses - 2 ¼″–3 ⅜″ (57 mm–85 mm) STC 51 to STC 54

Options include factory preinstalled acoustic glazing up to STC 54.

Fire-rated wood doors are available that achieve a 90-minute fire rating.

Acoustic Wood Raised Panel Doors and Steel Frame

Performance Rating: STC 47

Door: Cherry Veneer

Frame: Welded Steel






Acoustic seals are a very effective means of stopping sound from getting through an acoustic door and frame assembly.

Seals are utilized around the perimeter of the door, at the bottom of the door against the threshold, and at any astragal

for paired openings. Some manufacturers promote their acoustic doors by indicating that they have tested their door

panels as inoperable panels. While this is a legitimate approach to door panel development, it is insufficient to ensure

the acoustic performance of an operable acoustic door and frame assembly.

As well, some manufacturers promote the use of acoustic seals but have not tested them with a certified acoustic door

and frame. The use of an entire tested assembly is critical to successful acoustic attenuation.

Acoustic seals cannot simply be added to third-party door panels or door frames and achieve high-performance STC

ratings. Neither can door panels be supplied in a door opening without tested perimeter seals and acoustic frames.

Fully tested assemblies supplied by a single manufacturer should be specified, and a component approach should not

be permitted.

Acoustic Seals






Table II clearly shows that even the most robust door seals combined with off-the-shelf door/frame products produce

modest acoustic results. The old saying that “a chain is only as good as its weakest link” is especially apt in this case.

Architectural Grade A wood and conventional steel doors are incapable of creating a high-level acoustic barrier. Only

when an acoustic panel is engineered to function as an operable acoustic door and is combined with a frame and

specially-designed acoustic seals can superior results be achieved. When specifying, ensure that the assembly has

been tested as a complete, operable acoustic assembly in accordance with ASTM E90.

Acoustic Seals

Source: www.acoustics.com/ansi_education.asp




http://www.acoustics.com/ansi_education.asp



A variety of accessories are available for acoustic assemblies, such as those listed below.

Accessory Options

• Butt hinges (used for level swing doors up to STC 52)

• Cam lift hinges (necessary only above STC 52)

• Vision lite kits, glazing stops (for acoustic steel and acoustic wood doors)

• Glass and glazing (for use in doors, or borrowed or side lite frames)

• Fixed or removable acoustic mullions

• Fire labels

Glass and glazing components: Where practical, glass should be factory installed in doors.

Accessory Options




Review Question

What are the attributes of stainless steel that contribute

to meeting the stringent demands of specialty healthcare

applications?

Answer

What are the attributes of stainless steel that contribute

to meeting the stringent demands of specialty healthcare

applications?

• Easy to clean and maintain

• Retains its strength at high temperatures (offers a

three-hour fire rating)

• Ease of fabrication

• Design and function versatility

• Recyclable

• Durable/impact resistant/corrosion resistant

• Antimicrobial properties

• Range of aesthetics to meet particular design

requirements



Specialty: Bullet-Resistant Doors / Security Doors






Healthcare personnel face considerable risk of job-related violence.

• According to a Health Facilities Management Security Survey, security systems were the number one major

investment made by hospitals nationwide in 2016. In the same survey, 75% of hospitals stated that the main source

of security challenges is aggressive behavior from patients, family, friends, and others.

• In 2015, the Occupational Safety and Health Administration (OSHA) revealed that roughly 75% of all workplace

assaults occurred in healthcare facilities. Furthermore, one quarter of healthcare-related, on-the-job casualties are

the result of such assaults.

• Studies from the International Council of Nurses indicate that healthcare employees are assaulted more frequently

than prison guards and police officers, making it one of the most hazardous professions in the United States.

The Need for Bullet-Resistant Doors & Frames

Source: https://cibulletproof.com/hospital-security-needs-bulletproof-support




https://cibulletproof.com/hospital-security-needs-bulletproof-support



Let’s look at the sources of hospital violence that include patients themselves and their family members. As indicated

below, patients and family members are becoming more physically aggressive towards healthcare staff.

As well, today’s hospitals are a holding facility for mentally ill patients, criminals, and drug users needing medical

services. The task falls to hospital security professionals to manage threatening behavior and to train hospital staff to

recognize issues. Training helps staff identify behavior that could lead to escalated situations and provide a process for

de-escalating situations and preventing injuries. But when weapons are involved, hospital staff needs additional

protection.

Listed below are the top incidents of hospital violence in the United States throughout 2016:

• 51% increase in patient and/or family violence towards healthcare staff

• 44% rise in patient and/or family violence towards healthcare personnel, outside of the emergency department

• 38% increase in attacks and assaults*


*Source: https://cibulletproof.com/hospital-security-needs-bulletproof-support




http://cibulletproof.com/hospital-security-needs-bulletproof-support




Security personnel are not able to

handle these situations alone; bullet-

resistant solutions are a method to

protect healthcare staff and provide a

safe environment for patients. By

evaluating security risks early in the

design process, hospitals can minimize

costs and most importantly, increase

safety.






Bullet-Resistant Doors & Frame Assemblies

Bullet-resistant door and frame assemblies provide an unparalleled level of

security for personnel and patients in emergency rooms or mental health

areas where the intersection of general public space and hospital space

occurs. Doors are available in steel or in a range of wood veneers and plastic

laminates and are designed to resist attack ranging from small arms

handguns to military assault rifles. Many assemblies are able to operate

using conventional heavyweight builders’ hardware.

Bullet-resistant openings are certified and supplied as complete assemblies,

comprising frame, door(s), and vision lite kits, including bullet-resistant glass,

which is factory installed in the vision lite kit.

These types of doors and frames can offer architecturally pleasing, fail-safe

ballistic security in medical complexes within the budget criteria of most

facilities.






Bullet-resistant door and frame assemblies are tested in accordance with UL 752 and assigned a rating level from 1 to

10 that indicates how resistant the door unit is to gunfire. UL Levels 1–3 protect against handgun assault and are

commonly referenced in ER specifications. Glazing is available for all levels. Cast butt hinges or super-heavy-duty

hinges are available from the door manufacturer for all applications.

UL 752






UL 752

Listed below are the UL 752 test pass requirements for bullet-resistant

assemblies:

• Projectile must not completely penetrate the assembly

• Fragments of projectile must not pass through the assembly

• No spalling (fragmentation) of the assembly to the degree that injury

would be caused to a person standing directly behind the assembly






Bullet-Resistant Wood Door & Steel Frame

Bullet-resistant wood doors and steel frames combine ballistic security with the

appearance of standard door and frame products.

Face veneers are available in a wide variety of paint grade or stain grade options

to match other commodity veneers and finishes when desired.

Bullet-resistant wood door products are tested to provide ballistic protection in

conformance with UL 752 Levels 1 through 8.




Review Question

How can steel or wood door materials contribute toward

earning points in the LEED v4 green building program?

Answer

How can steel or wood door materials contribute toward

earning points in the LEED v4 green building program?

EQ Credit, Acoustic Performance, 1–2 points

• Option 1: Speech Privacy, Sound Isolation, and

Background Noise (1 point)

• Option 2: Acoustical Finishes and Site Exterior Noise

(1 point)



Security Doors

The next topic for discussion is security doors.

Security doors are available that have a steel core for durability and strength,

encased with hardwood door edges and face veneered with wood veneers (plus an

MDF backer) or plastic laminate face veneers.

The veneers can be matched to the overall building standard to avoid the sterile,

clinical feel of a traditional hospital. These doors offer the warm look and soft feel of

wood while providing the robust strength and performance of steel.






Security assemblies for patient room applications are typically antibarricade doors that may be opened in either

direction. They are often supplied with a break-away stop in case the door is barricaded from within. The break-away

stop allows access to permit the door to swing in the opposite direction. These types of assemblies interface with

antiligature and nonmicrobial builder’s hardware, where required.

Security doors can be used for rooms where there is an increased need for security, such as in:

• patient rooms in psychiatric hospitals

• patient spaces in healthcare facilities, or

• anywhere where patient or personnel security is a key concern.

Security Doors






New York State Office of Mental Health (NYS-OMH) Guidelines is a document that offers guidance with respect to

patient safety features in inpatient psychiatric environments.

The guidelines were developed to provide a selection of materials, fixtures, and hardware that the NYS-OMH has

evaluated and supports for use within inpatient psychiatric units to further the agency’s goal of minimizing the risk of

harm to people in inpatient facilities.

New York State Office of Mental Health Guidelines






The guidelines grow out of the standards of new construction for the NYS-OMH inpatient hospitals in order to provide

guidance for:

• existing NYS-OMH state-operated inpatient facilities

• psychiatric units in NYS-OMH licensed Article 28 general hospitals, and

• NYS-OMH licensed Article 31 hospitals.

The NYS-OMH guideline has become the gold standard for behavior health facility designers and is referenced widely

by architects in all areas of the country.

New York State Office of Mental Health Guidelines






Specialty: Radiation Shielding / Radio Frequency Attenuating






The Need for Radiation Shielding

A demanding requirement exists for the containment of radiation in treatment

areas of a healthcare facility, such as conventional x-ray rooms, PET scan

theaters, or modern CyberKnife® clinics.

The World Health Organization (WHO) has classified radiation as a

carcinogen and the risks of exposure are not insignificant.

Exposure to ionizing radiation can lead to a variety of health issues, such as

hair loss, cataracts, birth defects, and the development of cancers. These

deleterious effects can manifest themselves not only in the exposed

individuals but in their offspring as well. Changes may emerge within a time

frame of a couple of hours to many years, depending on the amount and

duration of exposure to the individual.






Radiation Shielding: Lead-Lined Doors & Frames

Lead-lined assemblies are available that combine protection against radiation

with the appearance of standard door and frame products. These lead-lined

door and frame assemblies provide operational certainty when combined with

complementary constructed rooms.

Doors can be supplied with lead lining from 1/32″ thick to more than 1″ in

thickness. The most common lead amount is 1/16″, equaling roughly 4 lb per

sq ft. Note the weight and thickness of lead-lined doors is determined by the

thickness of the lead required to withstand specific levels of radiation. Lead-

lined doors can be hung on readily available heavyweight builders’ hardware

until door weight dictates the need for specialty hinges by the door

manufacturer. Fire ratings up to three hours are available.

Radiation-Resistant Door & Frame Assembly






Radiation Shielding: Lead-Lined Doors

Manufacturers supply the door and frame (both of which are lead lined) where the

frame connects to a lead-shielded wall system.

In the case of swinging and sliding doors, the sliding door simply overlaps the

wall. There is no need for sealing. Radiation travels in straight lines, like light;

therefore, it doesn’t find its way through cracks between doors and frames.






Listed below are some considerations related to radiation shielding.

• Protective shielding is required in any room where radiation is used. The room must have a predetermined thickness

of lead in the walls, doors, windows, etc.

• Radiation shielding must be designed by a qualified expert during the early planning stages to ensure the required

degree of protection is achieved. Note that the shielding requirements may affect the choice of location of radiation

facilities and type of building construction.

• Lead shielding requirements should be determined by a certified radiation health physicist based on the following

factors: energy, workload, orientation, distance, occupancy, material, and code and health requirements.

• Radiation shielding shall comply with all applicable requirements of National Council on Radiation Protection and

Measurements (NCRP) Report No.147 titled “Structural Shielding Design for Medical X-Ray Imaging Facilities.”

Radiation Shielding: Considerations






Radio Frequency Shielding

Next, we discuss radio frequency (RF) shielding.

Radio frequency shielding is needed in magnetic

resonance imaging (MRI) rooms for preventing

unwanted interference from anything emitting

radio frequencies, including cell towers, radio

stations, and computers.

These frequencies can enter the MRI scanner

and degrade the quality of the image. This results

in a distorted image that is not as clear as it

should be to accurately examine and diagnose

potential health concerns.






The door assembly is a critical part of RF shielding of an MRI room.

What is the purpose of an RF shielding door assembly?

An RF shielding door assembly reduces the amount of radio frequency and/or electromagnetic energy that is

transmitted across an opening. Often, RF door and frame assemblies are designed to achieve acoustic as well as radio

frequency attenuation.

How is the performance of an RF shielding door assembly measured?

Electromagnetic energy is generated in waves and occurs at different frequencies. The level of shielding is measured in

decibels and over a range of frequencies: lower range is considered magnetic, higher range is electronic. The

performance can be specified as a particular attenuation at a specific frequency (e.g., 40 dB at 1 GHz), as a consistent

attenuation across a band of frequencies (e.g., 25 dB from 400 Mhz through 10 GHz), or as varying attenuation across

a band of frequencies (e.g., 25 dB at 200 Mhz, 35 dB at 800 MHz, 40 db at 1.2 GHz).

RF Shielding Door Assemblies







Perimeter and bottom seals are an integral part of an RF shielding door

assembly’s performance and must be supplied as per the performance

requirements and configurations tested by the manufacturer.

The door, frame, and seal system conducts the electromagnetic energy through

the door to the seals, onto the frame, and then to a ground system. The entire

MRI room will be made of conductive material and be grounded using a heavy

ground wire that goes to a ground stake.

Materials can be provided in mild steel or stainless steel formats. They are

available in a range of performance requirements to meet a wide variety of

applications.






IEEE 299, “Standard Method for Measuring the Effectiveness of Electromagnetic Shielding Enclosures,” is the shielding

effectiveness testing standard that governs the RF shielding industry.

Description of IEEE 299:

“Uniform measurement procedures and techniques are provided for determining the effectiveness of electromagnetic

shielding enclosures at frequencies from 9 kHz to 18 GHz (extendable to 50 Hz and 100 GHz, respectively) for

enclosures having all dimensions greater than or equal to 2.0 m. The types of enclosures covered include, but are not

limited to, single-shield or double-shield structures of various construction, such as bolted demountable, welded, or

integral with a building; and made of materials such as steel plate, copper or aluminum sheet, screening, hardware

cloth, metal foil, or shielding fabrics.”

Presented on the following slide is a drawing of a 40 dB RF-shielded frame and door.








40 dB RF-Shielded Frame & Door






Fire-Rated Assemblies






Role of a Fire-Rated Assembly

In healthcare facilities, fire-rated door

assemblies play a vital role in minimizing

property damage by compartmentalizing

smoke, flames, and when needed, radiant heat.

More importantly, they save lives by providing

safe egress for patients, staff, visitors, etc.,

during a fire event.

Fire ratings are an option available on virtually

all of the specialty door products previously

discussed in this presentation.

This section begins with a review of the basic

requirements for fire-rated door assemblies,

followed by a discussion of the applicable tests

and standards.






Fire ratings up to 180 minutes are granted and issued under licence by third-party testing agencies and are labeled on

the products.

Fire-rated door assemblies must meet the requirements of the applicable building or life safety code, such as:

• the National Fire Protection Association (NFPA) 80: Standard for Fire Doors and Other Opening Protectives

• NFPA 101: Life Safety Code

• the International Building Code (IBC), and

• the International Fire Code (IFC).

Additionally, fire doors are required to be self-closing and positive latching.

Note that in healthcare facilities, fire door assemblies are required to be annually inspected and tested in accordance

with 2010 NFPA 80.

Fire-Rated Door Assemblies: Basic Requirements






Listed below are the standards and testing pertaining to fire-rated door assemblies.

• UL 10C, Positive Fire Pressure Tests of Door Assemblies

• UBC 7-2 (1997) Part 1

• NFPA 252, Standard Methods of Fire Tests of Door Assemblies

• ASTM E2074

Knowing the standards, testing, and code requirements are crucial in order to properly specify the correct and code-

approved product for the application. Architects, designers, and specifiers can always contact the manufacturers for

expert support.

Standards & Testing

Please remember the test password EXPERT. You will be required to enter it in order to proceed with the online test.






Summary






• Healthcare door and frame assemblies tend to have need for multiple functions, such as fire ratings, acoustic

requirements, bullet resistance or security requirements, or radiation and radio frequency attenuating requirements.

• Design considerations for specialty doors include: type of materials; hygienic properties; durability, longevity, and

sustainability of materials; and sourcing reputable manufacturers.

• Due to its many favorable attributes (durability, recyclability, antimicrobial properties, and corrosion resistance)

stainless steel is used widely for items in a variety of markets, including healthcare, automotive, and food/beverage.

• To address speech privacy, acoustic door assemblies have been developed that satisfy sound attenuation

requirements and can meet green design goals.

• For security, bullet-resistant doors and frame assemblies are available that resist attack ranging from small arms

handguns to military assault rifles.

• For protection, radio frequency (RF) and electromagnetic interference (EMI) door and frame assemblies provide

operational certainty when combined with complementary constructed rooms.

• Fire rating is an additional function of the typical specialty door.

Key Points






Clark, Mark. “Why Hospital Security Needs Bulletproof Support.” Creative Industries, Inc., n.d., https://cibulletproof.com/hospital-security-needs-bulletproof-

support. Accessed March 2018.

“Fire Rated Doors: Standards, Testing and Glazing Requirements.” SAFTIFIRST, n.d., https://safti.com/articles/fire-rated-doors-standards-testing-and-glazing-

requirements. Accessed March 2018.

“Healthcare-Acquired Infections (HAIs).” PatientCareLink. Massachusetts Health & Hospital Association, Inc., n.d., https://patientcarelink.org/improving-patient-

care/healthcare-acquired-infections-hais. Accessed March 2018.

“IEEE Std 299-2006 (Revision of IEEE Std 299-1997) - IEEE Standard Method for Measuring the Effectiveness of Electromagnetic Shielding Enclosures.” IEEE

Standards Association. IEEE, n.d., https://standards.ieee.org/findstds/standard/299-2006.html. Accessed March 2018.

“Fire and Smoke Door Annual Testing Requirements in Health Care Occupancies.” National Association of Fire Equipment Distributors, September 2017,

https://www.nafed.org/latestnews/fire-and-smoke-door-annual-testing-requirements-in-health-care-occupancies. Accessed March 2018.

“Patient Safety Standards, Materials and Systems Guidelines.” New York State Office of Mental Health, 2018,

https://www.omh.ny.gov/omhweb/patient_safety_standards/guide.pdf. Accessed March 2018.

“Sustainable Stainless Steel.” The Stainless Steel Information Center. Specialty Steel Industry of North America, n.d., https://www.ssina.com/sustainability/#rcont.

Accessed March 2018.

“Three Kinds of Ballistic Barriers for Healthcare Facilities.” Total Security Solutions, August 2016, https://www.tssbulletproof.com/kinds-ballistic-barriers-

healthcare-facilities. Accessed March 2018.

References & Resources




https://cibulletproof.com/hospital-security-needs-bulletproof-support

http://safti.com/articles/fire-rated-doors-standards-testing-and-glazing-requirements

http://patientcarelink.org/improving-patient-care/healthcare-acquired-infections-hais

https://standards.ieee.org/findstds/standard/299-2006.html

http://www.nafed.org/latestnews/fire-and-smoke-door-annual-testing-requirements-in-health-care-occupancies

https://www.omh.ny.gov/omhweb/patient_safety_standards/guide.pdf

http://www.ssina.com/sustainability/#rcont

https://www.tssbulletproof.com/kinds-ballistic-barriers-healthcare-facilities



Thank you for taking this course. If you desire AIA/CES, state licensing, or

CE credits for another organization, please click on the button to commence

your online test. A score of 80% or better will allow you to print your

Certificate of Completion; you may also go to your AEC Daily Transcript to

see your completed courses and certificates.

Thank You

MORE COURSESpowered by

©2018, 2019 AMBICO Limited. The material contained in this course was

researched, assembled, and produced by AMBICO Limited and remains its

property. “LEED” and related logo is a trademark owned by the U.S. Green

Building Council and is used by permission. The LEED® Rating System was

authored by and is the property of the USGBC. Questions or concerns about

the content of this course should be directed to the program instructor. This

multimedia product is the copyright of AEC Daily.

Click Here to Take the Test

Questions? Ask an Expert

For additional knowledge and postseminar assistance, click on the link

below.

If you have colleagues who might benefit from this seminar, please let

them know. Feel free to revisit the AEC Daily website to download

additional programs.




http://aecdai.ly/aeccl

https://www.aecdaily.com/course.php?node_id=2024882&tabidx=taketest


https://www.aecdaily.com/


specialty doors for healthcare design

Documents