Don’t think they don’t see this stuff too…

By Steve MacArthur, Hospital Safety Consultant

While I don’t doubt that we will revisit this topic at some point in the not-too-distant future, there’s been a confluence (small pun intended) of recent materials relating to the management of waterborne pathogens.

And while I have surely mentioned this in the past, if you are not following (e-mail, the tweeting, the Instragramming and the Facebooking) Matt Freje and his team at HCInfo (, you are denying yourself access to the leading lights in the management of waterborne pathogens. When it comes right down to it, it’s not about compliance with this or that regulatory body or agent thereof, it’s about providing the safest of environments to patients and staff, and the folks at HCInfo are the “real deal.”

So why, you might ask, would that be an area of concern? Read on, dear friend, read on…

First up, we have the latest from the folks at the Centers for Disease Control and Prevention (CDC), outlining a rise in legionella cases over a 25-plus year period (1992-2018—the rates were fairly stable from 1992 to 2003) for reasons that are, apparently, not that easy to discern from an epidemiological standpoint, though there would seem to be factors relating to racial disparities, geographic locations, and more pronounced seasonality.

The CDC continues to recommend the use of Water Management Programs (WMP) for buildings with complex water systems (I suspect most of you would fall into that category). With the increase in cases, I think we can safely say that this is going to be a “big ticket item” on the survey shopping list for the next little while. You can see the whole picture here:, but I think what it all boils down to (another small pun intended—I’m just full of ’em today) is being assured that your water systems are not harboring any risky interlopers. But how easy is that?

Bringing us to the next item: Much as the Ancient Mariner, we have water, water everywhere, and while we try to ensure that it is all consumable to the point that it needs to be, there are a lot of opportunities for good water to go bad.

The article provides a lot of points to consider, but the long and short of it is that you have to have a properly designed and maintained WMP that truly identifies the areas of vulnerability (greater and lesser) and establishes a means of mitigating those vulnerabilities to the extent possible. I recognize it’s a lot of work and fairly specialized work at that, which I think lends credence to summoning outside assistance from time to time.

I understand the benefits of the homegrown solution when it comes to budget time, but all it takes is one case to fall out and erase any and all savings derived from the internal process. As we are nearing the typical budget forecasting period (if not knee-deep in it), you might want to find out what it would take to have your current process evaluated, particularly if it’s a in-house model plan. We are all better off if we can somehow get to a standard practice for this stuff – seeing the same thing wherever they go is a good way to keep surveyors at bay.

As a closing thought, I saw a sign today at the airport in Newark as I was standing in line for my morning caffeination meditation and I thought that it would speak volumes to anyone within the sound of my voice:

Thank you so much for showing up – it means the world to me!


About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at