View
5
Download
0
Category
Preview:
Citation preview
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 1
Safely Managing Construction/Renovation and
Maintenance in Healthcare
A Facilities Management Perspective
Bryan Connors, MS, CIH, HEMHealthcare Practice Leader, EH&EFebruary 10, 2009
2
Agenda Agenda
• The Joint Commission Requirements • Case Studies (What Can Go Wrong)• Management of Data and Program
Documents • Proven Management Techniques
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 2
3
Why Do We Care About PCRA?Why Do We Care About PCRA?
• Outbreaks of hospital-acquired mold infections
• Minimizing liability• Compliance • Improving flow of work
4
Proven Success Strategies Proven Success Strategies
• Clear Responsibilities• Central Coordination • Consistent Review Process
Committee, Inspections, Permits
• Competencies/Skills• Metrics, Follow-up• Contactor Training
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 3
5
Construction in Healthcare Construction in Healthcare
6
Examples of the Risks Examples of the Risks
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 4
7
8
PCRA Components PCRA Components
PCRA Risk Mitigation Program
ILSM
Utility Impacts, Noise, Vibration, IAQ
ICRA
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 5
9
Joint Commission RequirementsJoint Commission Requirements
The PCRA process should identify:1) Potential impacts on air quality
10
Joint Commission RequirementsJoint Commission Requirements
2) Potential impacts on fire and life safety
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 6
11
Interim Life Safety MeasuresInterim Life Safety Measures
• Major deficiencies in the life safety code • May be due to construction or other
causes of deficiencies
12
Life Safety Case StudyLife Safety Case Study
• Hot work + sprinkler impairment = ?
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 7
13
Joint Commission RequirementsJoint Commission Requirements
3) Effects of noise and vibration4) Utilities and medical equipment
14
Joint Commission RequirementsJoint Commission Requirements
5) Potential impacts on Infection Control
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 8
15
Infection Control Risk MitigationInfection Control Risk Mitigation
• Construction = Dust• Dust = Mold• Mold + High Risk Patients = Elevated Risk
Construction Project Type
IVIII/IVIIIIHighest risk groupIVIII/IVIIIHigh risk group
IVIIIIIIMedium risk groupIII/IVIIIIILow risk group
Type DType CType BType APatient risk group
16
ICRA Case Study ICRA Case Study
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 9
17
Good Bad
View from inside site
Examples: Containment Practices Examples: Containment Practices
18
Example: Life Safety Risks Example: Life Safety Risks
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 10
19
What Can Go Wrong What Can Go Wrong
• Nosocomial fungal infections • Staff injury and illness• OSHA inspections• Joint Commission Accreditation • Insurance premiums and liability • Staff complaints and dissatisfaction
20
Root Causes of FailureRoot Causes of Failure
• Interdepartmental responsibilities = ambiguity, lack of “ownership”
• Construction contractors focused on job completion & schedule
Subcontractor management • Limited hospital resources/resource
allocation • Contractor orientation & unfamiliarity with
healthcare environment
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 11
21
Consistent PCRA ProcessConsistent PCRA Process
22
Permits for Each ProjectPermits for Each Project
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 12
23
Inspection Data and Program Inspection Data and Program MetricsMetrics
24
Other Issues to Consider Other Issues to Consider
• Site inspections, deficiency resolution • Contractor vetting and selection
Management of sub-contractors • Include PCRA and safety performance
requirements in contract documents• OSHA compliance issues
Asbestos, LO/TO, confined space• Above the ceiling permit,
fire stopping, hot work permit
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 13
25
Proven Success Strategies Proven Success Strategies
• Define the management process
• Clearly define roles• Assure accountability
26
Proven Success Strategies Proven Success Strategies
• Vet/select contactors and subcontractors
Train contactors
• Determine vulnerabilities
Act to address the vulnerabilities
Safely Managing Construction/Renovation and Maintenance in Healthcare: A Facilities Management Perspective
February 10, 2009
Environmental Health & Engineering, Inc.800-825-5343 • www.eheinc.com
Page 14
Safely Managing Construction/Renovation and
Maintenance in Healthcare
A Facilities Management Perspective
Bryan Connors, MS, CIH, HEMHealthcare Practice Leader
bconnors@eheinc.com800-825-5343
Recommended