Mac's Safety Space: If you don’t properly maintain the environment…

…how can you effectively manage infection risks?

As we continue our crawl through The Joint Commission standards changes, let’s drop in on the changes in the Infection Control chapter. Although the changes aren’t necessarily pointed at the physical environment, there’s a whole lot of content that can—and likely will—be applied to how things play out in the physical environment, which, after all, is where a lot of the patients are.

The changes mostly reflect the rigor to be applied to the overarching program elements, but there are bits and pieces for which one should be mindful. For example, maintaining a clean and sanitary environment is specifically called out as part of any healthcare organization’s implementation of its infection control program (not a shocking thing to require, but perhaps a means of ratcheting up the survey impact). There already exists a requirement in the Environment of Care (EC) chapter for areas used by patients to be clean and free of odors, so this potentially provides the opportunity for two survey findings relating to a single set of conditions in the environment. (I’d like to think that a one-off condition, say, a single stained ceiling tile would not result in a two-fer in the matrix.)  That said, there are a number of EC chapter references “sprinkled” throughout the updated Infection Control standards: water management, staff education relative to managing the environment, management of infection control risks during construction, renovation and maintenance activities, managing the equipment associated with sterilization and other instrument processing considerations, management of environmental conditions in procedural areas. As each survey year unfolds, the ties between infection control and risks in the environment get a little stronger and a little more widespread in their application (at least from a standards perspective; infection control and the environment are basically two side of the same coin).

It all kind of comes back to the notion that, purely from a risk standpoint, the inspection, testing, and maintenance of life safety systems, features, and equipment is critically important, and healthcare generally does a very good job on that front (there tend not to be so many harm events relating to life safety in hospitals). But the impact of effective management of infection control risks might be no better than your organization’s last healthcare-associated infection (HAI), which probably occurred more recently than your last fire in a patient area.

At this point, I think that one of the clear paths forward when it comes to providing effective healthcare is the reduction of infection control risks in the environment. It’s likely a struggle that will occur for as long as there is an environment to manage (a daunting thought), but incremental improvement is still improvement—so let’s get busy!

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as 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.