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Ventilation Considerations During Healthcare Construction

Every containment is a temporary departure from how the hospital's air systems are meant to run. Someone has to decide how far that departure reaches and what it takes to put the building back.

A ventilation management program is the hospital's written plan for how its air systems are supposed to operate. It classifies spaces by risk, sets the conditions each one must hold, assigns responsibility, and defines what happens when a room falls out of range. ASHRAE and ASHE published Guideline 43 in 2025 to give facilities a framework for developing one. Many hospitals either have no VMP or have one that does not address construction. That gap matters for ICRA work. An ICRA covers a single project and closes when the project closes. The VMP is permanent and covers the entire building. Every project is a temporary, deliberate departure from the VMP, and someone has to determine how far that departure extends and what is required to restore the building afterward. Most of the difficulty involves air. An ICRA calls for negative pressure in the work zone. Holding that pressure requires air to physically leave the containment, and that air has to be replaced from somewhere in the building. Remove enough of it and you can reverse the pressure relationship in a room several doors away that appears nowhere on the permit. Failure to control ventilation systems has ranked among the most frequently cited higher-risk physical environment findings from both The Joint Commission and DNV for several years. We will reference Guideline 43 throughout and point attendees to it. Bring a current project. The second half of the session is open questions.