Flatten the curve – stop the spread!

By Steve MacArthur, Hospital Safety Consultant

This week, our friends from Chicagoland unveiled the Top 5 Most Challenging Requirements for the usual run of accredited healthcare programs: https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/joint-commission-online/may-11-2022/#.Yn1Sn-jMI2w

As is generally the case, my focus this week is on those challenges relative to accredited hospitals, but if anyone in the studio audience has a question or concern relative to any other of the healthcare settings, please do ask—I will endeavor to provide you with something useful. So, on to the main event…

Of the Top 5 most challenging requirements, I would count 4 of the 5 as being squarely in the physical environment with the major areas of focus being the management of behavioral health patients and the management of infection control risks (surprise, surprise, surprise!). Topping the list is high-level disinfection in all its glory—this is one of those things that is very difficult to get perfect every time and with humans being involved, imperfections can become the order of the day. Even folks that do it really well can have lapses!

I’m going to bundle No. 2 and No 4 as they each have implications for the management of behavioral health patients. National Patient Safety Goal 15 deals specifically with the whole risk assessment thing (we’re going to talk more about assessing risk next week, I think), but EC.02.06.01 (which has functionally become very much like a general duty clause for all manner of things) can include specific risks in the environment that are not being managed correctly.

I was thinking that perhaps as we have endured more than a survey cycle (typically, in any three-year period, everyone gets surveyed) that this would fade a bit on the hot list (and yes, I completely recognize that the management of behavioral health patients is probably the defining challenge for healthcare—COVID just increased the degree of difficulty), but that appears not to be the case.

Rounding out the Fearless 5 is the overall management of utility systems components/equipment. There are lots of opportunities for things to go sideways – ventilation issues, water management (I suspect they’ll be leaning pretty heavily on water—expect lots of splashing), labeling of utility systems components—to my mind, this is the “bridge” that will bring the management of the care environment and the management of infection risk into the seamless whole it should always have been. I have been harping on the collaborative nature of this whole megillah and the survey vulnerabilities squarely relate to the “gaps” in practice, policy, probably a whole host of other things.

There’s something about this that makes me think we need to pay close attention to the melding of the EC & IC disciplines—we knew it was coming, but it does feel like it’s really happening.

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 stevemacsafetyspace@gmail.com.