Even if you have had the opportunity to review the new standards published January 9, 2017, chances are you could have missed the two simple words, “general maintenance”, inserted in EC.02.06.05, EP 2 which now states,
“When planning for demolition, construction, renovation, or general maintenance, the hospital conducts a preconstruction risk assessment for air quality requirements, infection control, utility requirements, noise, vibration, and other hazards that affect care, treatment, and services.”
Our first hint of this subtle yet profound change came during George Mills’ presentation at the 53rd Annual ASHE Conference and Technical Exhibition last year in Denver. During his presentation, Mr. Mills mentioned a proposed revision to EC.02.05.05 (the Utility Standards) that would have required hospitals to have a process to manage the risks of maintenance and repair activities. Following the introduction of this proposed change, Mr. Mills made what can only be described as an impassioned plea for all of us to get involved in preventing hospital-acquired illnesses. Given that approximately 1 in 25 patients will acquire an infection during their stay in our hospitals, it is certainly an effort we should all embrace.
The question is, how do we comply with this new requirement? Is it reasonable to expect our maintenance teams to stop before every work order and perform a documented risk assessment and develop a mitigation plan? Of course not. However, it is more than reasonable to expect an organization to minimize the risks associated with these activities, many of which are repetitive. Perhaps the most effective approach is to first look at high volume activities and their associated risks; then, develop plans and processes to minimize the risks each time these tasks are performed. It is also important to understand that the risks of even repetitive activities will vary based on where they are being performed and the status of the patients in the affected area. There is obviously much greater risk associated with replacing a light bulb in ICU than there is in Administration. Additionally, we should look at low volume, high risk procedures (e.g. changing HEPA filters) to ensure that all necessary precautions are taken to protect patients and staff.
These generalized risk assessments should be performed with the assistance of Infection Prevention and other clinical colleagues, as appropriate. Once the risks and mitigation strategies have been identified, proper staff orientation will be the key to ensuring these efforts result in real improvement rather than just a paper exercise.
Since our inception, MSL has been dedicated to eliminating hospital-acquired infections and improving patient safety. To this end, MSL has developed a simple PowerPoint presentation designed to be downloaded, modified to be organization specific, and used for staff training. It can be downloaded here. We encourage everyone to use it, improve it, and share it.
In December 2016, MSL made an official commitment to the Patient Safety Movement, an organization dedicated to the elimination of preventable patient deaths by 2020. We invite you to join this effort and stand by ready to assist in any way that we are able.
It is just two words, easily overlooked; however, we believe that once the intent of this change is fully realized, they will have a profound impact on patient and staff safety.