Magazine article Health Facilities Management

Creating a Culture of Safety: Facilities Professionals Play Bigger Role in Maintaining Patient Welfare

Magazine article Health Facilities Management

Creating a Culture of Safety: Facilities Professionals Play Bigger Role in Maintaining Patient Welfare

Article excerpt

Health facilities professionals know that creating a safe environment for patients is vastly more complicated than just implementing effective hand-hygiene programs and installing seamless epoxy flooring to prevent slips and falls.

In today's health care climate, managers held to increasingly higher standards for performance are charged with creating an entire culture of safety vs. focusing on a series of targets. And that is a much taller order considering that a culture shift encompasses everything from developing a shared mindset among leaders and staff to staying on top of changing laws and regulations to designing the facility--inside and out--for patient and staff safety.

For the foreseeable future, hospitals striving to reach long-term goals are setting their sights on key areas that move them closer to those goals, experts say. While many improvements are dictated by codes and regulations, hospitals also are putting in the extra work required to take patient safety to a higher level.

"Many changes are driven by compliance with codes and regulations, which, for the most part, do foster a safe environment, but many health care personnel also realize the importance of going above and beyond that threshold," says Chad E. Beebe, AIA, CHFM, CFPS, CBO, SASHE, the American Society for Healthcare Engineering (ASHE) deputy executive director of advocacy.

Often that involves a concerted level of teamwork. For example, before launching a new project, some designers and architects are shadowing hospital staff on their daily routines, making notes about potential safety enhancements to improve the design, says Joseph Sprague, FAIA, FACHA, FHFI, principal and senior vice president, HKS, Dallas.

"Factors like room proximity and workflow layout may contribute to stress, fatigue, disruptions and interruptions of the health care staff's duties that can increase errors and lead to safety incidents," Sprague says. "What we will do is incorporate changes into the design that address these issues."

Focus on infection control

For most hospitals, many high-priority safety improvements are connected to infection control, which impacts every area of the facility. Hospitals are making progress in reducing health care-associated infections (HAIs), according to a 2013 HAI progress report from the Centers for Disease Control and Prevention (CDC) that shows an 8 percent decrease in hospital-onset, methicillin-resistant Staphylococcus aureus bacteremia between 2011 and 2013 and a 10 percent drop in hospital-onset Clostridium difficile infections between 2011 and 2013.

Spurred by Affordable Care Act laws tying Medicare reimbursement to HAIs, hospitals are putting considerable time and money into preventing the HAIs that are still a major concern. According to the CDC, one in 20 patients has an HAI on any given day, and there are about 1.7 million cases--leading to 99,000 deaths--of HAIs in U.S. health care facilities each year.

"Infection control is the main focus for hospitals and I don't see it going away," says ASHE President-elect Terry M. Scott, CHFM, CHSP, SASHE, system director of engineering services, Memorial Hermann Greater Heights Hospital and Memorial Hermann Southwest Hospital, Houston. "It's at the forefront of health care now with Medicare reimbursement tied to infection control. Some facilities are losing money and some are gaining, but there are huge financial incentives involved."

Along with must-have systems, such as room-pressure indicators and alarms for monitoring the direction of airflow into or out of a room, hospitals will continue to explore new infection control technology.

Memorial Hermann spent $600,000 to develop computer dashboards integrated with the hospital's automated systems that continually measure air temperature and humidity in operating and isolation rooms, Scott says. Another recent addition at Memorial Hermann--"ball-in-the-wall" positive and negative pressure indicators--offer simple, visual cues (red or green pingpong-sized balls) indicating proper or improper airflow direction in isolation rooms, he said. …

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