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Dave Dagenais, SASHE, CHFM, CHSPSteve Jalowiec, PE, CHFM
AdvocacyProfessional
Development NetworkingInformation
Resource
Optimize the Health Care Physical Environment
Strategic Goals: Reputation, Capacity and Regulation
Reputation• Our members will have a reputation as highly
valued professionals with a specialized body of knowledge experience and competency of strategic, operational and business value to the entire enterprise.
Reputation Goal
• Increase the recognition of our strategic value to the organization
• Increase the level of competency within our profession
• Increase our confidence in ourselves and our ability to promote ourselves
• Increase the awareness by “C” suite for the value of “CHFM”
Reputation Goal - Continued
• Increase the awareness of the importance of maintaining the organization’s physical assets and the consequences of not maintaining our environment
• Increase the awareness by “C” suite of ASHE and local chapters
• Increase the number of high school graduates seeking a career path to our profession
Capacity• Our members will be supported by a nimble
association with the resources, relationships, decision systems and work processes necessary to achieve their envisioned future for the field.
Capacity Goal
• Decrease competition between national and local associations
• Increase the interaction and alignment of chapter and national activities
• Increase member awareness of the relevance and combined value of dual membership
Regulation• Our members will work in a regularity
environment characterized by good science, defensible economics, informed policymaking and clear decision authority.
Who Regulates Hospitals?
Source: American Hospital Association http://www.aha.org/aha/trendwatch/2011/11mar-tw-costofcaring.pdf
Regulation Goal
• Increase influence on policy making• Decrease the inconsistency and conflict in the
development and enforcement of codes and standards
• Increase management awareness and appreciation of what we do
• Increase the use of science
Regulation Goal - Continued
• Abandon the existing system and devise one in which all codes will be based on a cost justification/benefit analysis
• Create unified code (one code)• Decrease the number of AHJ organizations
Note: Regulation Goal is Assigned to Advocacy Committee
ASHE Advocacy
• ASHE Staff Advocacy TeamoManages the day-to-day advocacy effortso Provides support to members as needed
• Advocacy Committeeo Supports strategic initiativeso Develops community action plansoManages task force’s projects
ASHE Advocacy
• Chapter advocacy liaisonoManages the day-to-day advocacy efforts at the
chapter levelo Provides information to the chapters
ASHE Advocacy Committee Action Plan 1Clipping Service
Scope of Work
• Develop process to monitor and deliver results to ASHE staff.
• Staff to continuously monitor results and report to ASHE Advocacy Advisory Committee and/or Members.
ASHE Advocacy Committee Action Plan 2Up-to-date Codes and Standards
Scope of Work
• ASHE had joined with TJC to pressure CMS• Identify key legislative entities or individuals in D.C. • Determine the interest which AHA has in assisting ASHE in the
legislative effort.• Contact other health care organizations and other entities with
similar interests or resources.• Identify conflicts within codes and standards that lead to higher
costs.o Survey ASHE facility based membershipo Utilize advocacy liaisons
ASHE Advocacy Committee Action Plan 3Evidence Based Codes
Scope of Work
• Develop a process that ensures that facts are checked and science is used for pending code changes
• Convince code making authorities to take a more rigorous approach to ensuring that only fact-based changes are made to their codes or standards.
• Develop a list of universities and organizations that support this initiative and are willing to provide necessary research for changes to the organizations defined by this action plan.
ASHE Advocacy Committee Action Plan 4Incorporation of Commissioning Guidelines
Scope of Work
• Create a specialty subgroup recognized by the Healthcare Guidelines Revision Committee:
• Incorporate the Commissioning Standards into the Healthcare Guidelines Revision Committee process as a reference
• Incorporation of standard into the FGI Guidelines by reference.
ASHE Advocacy Committee Action Plan 5Guidelines Adoption
Scope of Work• Develop an action plan to encourage and
educate state authorities on the benefits of adopting latest editions of the FGI Guidelines.
• Increased awareness by the State Authorities of the recommendations of the FGI Guideline.
• Promote Consistency of rules from state to state.
• Broaden interpretation base for review and update of both Guidelines.
Guideline Goals
ASHE Advocacy Committee Action Plan 6Advocacy Highway
Scope of Work
• Develop a initial meeting of the chapter advocacy liaisons to:o Inform them of the ASHE process on advocating at the national
level,o Gather information from the state societies on codes and standards
issues within their states or regions, ando Educate the advocacy liaisons about the “One Code” initiative so
they can meet with state and local officials to explain the rational for making these changes.
• Schedule a series of quarterly conference calls to follow up on ASHE initiatives and continue to gather codes and standards information.
• Review success of initial face to face meeting and conference calls and develop proposal for moving forward.
Repaving the ASHEAdvocacy Highway
Advocacy work affects you
• Ever asked yourself questions like: “The code says I have to do what? Who writes these things? Do they have any idea how things work in the real work?”
• Through the process of advocacy, ASHE members have caused obsolete standards to be replaced and performance-based standards to be adopted.
Poor codes cost money without improving safety
• ASHE estimates that the hospitals spend more than $4 billion a year because of conflicting codes and standards, overregulation, unjustified code enforcement, and misinterpretations.
• Even things that may seem small and not worth fighting in an individual hospital could have a profound effect nationwide.
Example of Poor Code Interpretation
• A 2010 citation from a state fire marshal required OR supply cabinets to have automatic sprinkler heads installed inside, or holes drilled in the top of the cabinet.
• If all states required sprinklers in OR cabinets, the estimated cost to the health care industry would exceed $425 million.
Example of Poor Code Interpretation
• CMS surveyors have cited numerous facilities for microwave ovens and toasters not listed as “hospital grade” – even though no “hospital grade” microwaves or toasters are currently available on the market.
• Assuming commercial-grade appliances would satisfy CMS, this interpretation could cost the health care industry $30 million.
Important to Share Information
• ASHE advocacy leaders can act to help rectify inappropriate code interpretations where appropriate. They can also use the information to make the case nationally for uniform codes and standard application.
• But that can only happen if ASHE advocacy leaders know about the problems. That’s why communications through the Advocacy Highway are so critical.
Learning from ASHE• ASHE provides chapter
advocacy liaisons with up-to-date information on national advocacy issues affecting health care facilities.
• ASHE provides resources and tools to empower chapter advocacy liaisons.
Learning from liaisons• ASHE wants to hear from
chapter liaisons about regulatory issues affecting chapter members.
• ASHE will use this information, collected nationwide, to help build the case for uniformly applied and interpreted codes, which could save billions of dollars.
The Highway Is a Two-Way Street
Repaving Work Underway
• ASHE advocacy leaders met in December with chapter advocacy liaisons from Gold- and Platinum-level ASHE chapters.
• ASHE staff and the liaisons will continue to communicate so that information moves quickly along the advocacy highway.
Ways Chapters Can Help
• Spend a few minutes of chapter meetings discussing codes and standards issues affecting your members.
• Report poor code interpretations or other advocacy information to ASHE through the Advocacy Highway website form:
http://www.ashe.org/advocacy/highway/dhtml/communicate.dhtml
Get Involved• ASHE is a member-based organization: “We
Are ASHE.”• Getting involved with the code development
process can impact codes and potentially save your facilities money and time.
• To get involved, contact o Steve Jalowiec: [email protected] Dave Dagenais: [email protected] Chad Beebe: [email protected]
NEHES Advocacy EffortsAdvocacy Liaisons
• Steve Jalowiec• Dave Dagenais
• Available to present ASHE Advocacy Highway at a chapter meetings• Each state should appoint a state advocacy representative to coordinate local advocacy highway efforts.
• Initiate code issues and questions and send up through NEHES Advocacy Liaisons
