I think the people down the hall know who we are…

By Steve MacArthur, Hospital Safety Consultant

As we start moving (in what is likely to be a sprint) towards the end of the year, a couple of items for your consideration.

First up, in the December edition of Perspectives, we have another brick in the road that will forever link the management of the physical environment as a function of infection control and prevention. You and I have traveled this road (paved, as it is, with good intentions) for quite some time and while we will continue to see lots and lots of findings in the other physical environment disciplines (which makes us, in a manner of speaking, disciples…), the crossover / inextricable ties between the environment and IC are only going to serve as means of pushing the risk factors through “low” to “moderate” and, finally to “high”, with a sprinkling of “immediate threat to life” findings. And if you want to catch a glimpse of the battlefield ahead, the December Perspectives is a pretty good place to start.

I will forever stipulate that, in the absence of an appropriately maintained environment, the prevention and control of infections is (as might be heard in certain parts of the Northeast) wicked hahd! And when it comes to the practical matter of supporting the environment by way of utility systems equipment, we have something of a perfect storm of complex systems and very succinct expectations (and succinct expectations that do not always provide a clear path to compliance). By “succinct,” I think I’m mostly leaning towards the absolutes that, while easy to police during rounds, can be challenging from an operational standpoint. There are a lot of moving parts to the environment and each of those moving parts needs to be (at least metaphorically) maintained (cleaned, lubricated, inspected) at peak operating condition every moment of every day or suffer the consequences.

As I think we’ve noted in the past (I could look, but if we haven’t noted this, then shame on me), there are no perfect buildings (even the new ones are only perfect until people get in ‘em) and the survey process “lives” to identify those imperfections in as many applications / situations, etc., as possible. As with just about everything, there are painfully few “silver bullets” (magic beans?) that will give us a solid win, so it’s just keeping an eye on the whole megillah. As we’ve also noted, it may get easier from time to time, but it never gets easy…

On a closing note (and I am really quite torn about this), OSHA has (at least temporarily - https://www.osha.gov/coronavirus/ets2) suspended enforcement of its vaccination mandate as it has been challenged in court (and a stay granted). As we experience some spiking (and a new variant – oh boy, just in time for the holidays), I’m thinking the timing of this is not going to work in favor of those on the healthcare front lines. If, like me, you’d be OK with this all being eradicated, the vaccine is probably the best shot we have at the moment, but it does appear that personal freedoms (or what are perceived as personal freedoms) are having an undue influence on the health and safety of others. Not sure how this will all play out, but I think, in the meantime, we’re going to be in the hot seat yet again…

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.