Preparing for JCAHO s Unannounced Survey Process
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1 Preparing for JCAHO s Unannounced Survey Process Understanding the Environment of Care from the Environmental Services Perspective A program presented by SAFETY MANAGEMENT SERVICES, INC Arlington Heights, IL (877) ** info@safemgt.com SMS, Inc,,
2 Key Focus Points for Environmental Services Involved in all aspects of the organization Visit most departments on a daily basis Understand the interrelationships Participate in all areas of the Environment of Care Most visible entity during the survey process SMS, Inc,,
3 Key Points of the Survey Process Quality & safety of care Focus on opportunities for improvement Continuous accreditation process SMS, Inc,,
4 Key Components Focus on Patient Safety issues National Patient Safety Goals (NPSG) Patient Safety issues in the Environment of Care Key requirements for Survey SMS, Inc,,
5 Key Components Tracer Methodology Systems approach to evaluation The tracer is randomly selected Followed by surveyor through care sequence Actual cases are examined Questions asked at any time Continual building tour SMS, Inc,,
6 Making Accreditation Decisions Surveyors will evaluate: Staff knowledge Staff behavior Environmental conditions Management of programs SMS, Inc,,
7 National Patient Safety Goals 2006 Improve the accuracy of patient identification Improve the effectiveness of communication among caregivers Improve the safety of using medications Reduce the risk of health care-acquired acquired infections (Most notably hand washing) Accurately & completely reconcile medications across the continuum of care Reduce the risk of patient harm resulting from falls SMS, Inc,,
8 National Patient Safety Goals Added for 2007 Encourage patients involvement in their own care as a patient safety strategy Identifies safety risks inherent in the patient population (Safety assessment for behavioral patients). SMS, Inc,,
9 Standards for Managing Risk EC.1.10 Safety EC.2.10 Security EC.3.10 Hazardous Materials & Waste EC.4.10 Emergency Management EC.5.10 Fire Safety EC.6.10 Medical Equipment EC.7.10 Utility Systems SMS, Inc,,
10 Standards Physical Environment EC.8.10 Establish & maintain an appropriate environment EC.8.30 Design & construction SMS, Inc,,
11 Standards Measuring and Improving EC.9.10 Monitors conditions EC.9.20 Analysis & resolves issues EC Improves the environment SMS, Inc,,
12 Managing Safety Risks - EC.1.10 SMS, Inc,,
13 Managing Safety Risks EC.1.10 EC Conducts proactive risk assessments SMS, Inc,,
14 Managing Safety Risks EC.1.10 EC Maintains all grounds & equipment SMS, Inc,,
15 Maintaining A Safe Environment EC.1.20 Conducts environmental tours to identify hazards Twice each year area where patients are served Once each year in areas where patients are not served SMS, Inc,,
16 Smoking Policy EC.1.30 Covers all buildings Prohibition for outpatient & child/adolescent Exceptions long term care settings, & medical authorization Fire safety & health precautions must be taken Patient education required if patients smoke Monitoring & enforcement, & compliance strategies for eliminating violations required SMS, Inc,,
17 Managing Security Risks EC.2.10 SMS, Inc,,
18 Managing Security Risks EC.2.10 EC Maintains patient, staff & visitor identification program SMS, Inc,,
19 Managing Security Risks EC.2.10 EC Prevention Response Identifies & implements infant and/or pediatric abduction procedures SMS, Inc,,
20 Managing Hazardous Materials & Waste Risks EC.3.10 SMS, Inc,,
21 Managing Hazardous Materials & Waste Risks EC.3.10 EC Develops & maintains a management plan SMS, Inc,,
22 Managing Hazardous Materials & Waste Risks EC.3.10 EC Maintains inventory of hazardous materials & waste SMS, Inc,,
23 Managing Hazardous Materials & Waste Risks EC.3.10 EC Process for selecting, handling, storing, transporting, using & disposing of: Chemicals Chemotherapeutics Radioactive Infectious including sharps SMS, Inc,,
24 Managing Hazardous Materials & Waste Risks EC.3.10 EC Provides adequate space for handling & storing hazardous materials SMS, Inc,,
25 Managing Hazardous Materials & Waste Risks EC.3.10 EC Monitoring & disposal of hazardous gases & vapors SMS, Inc,,
26 Managing Hazardous Materials & Waste Risks EC.3.10 EC Identification & implementation of emergency procedures Spills Exposures SMS, Inc,,
27 Managing Hazardous Materials & Waste Risks EC.3.10 EC Maintaining documentation such as permits, licenses, etc. EPA disposal Medical waste disposal contract Radioactive waste license SMS, Inc,,
28 Managing Hazardous Materials & Waste Risks EC.3.10 EC Maintaining waste manifests Medical waste Chemical waste Radioactive waste SMS, Inc,,
29 Managing Hazardous Materials & Waste Risks EC.3.10 EC Properly labeling hazardous materials & waste SMS, Inc,,
30 Managing Hazardous Materials & Waste Risks EC.3.10 EC Properly separating hazardous materials & wastes & processing areas from other areas SMS, Inc,,
31 Emergency Management EC.4.10 EC Conducting a Hazard Vulnerability Analysis (HVA) SMS, Inc,,
32 Hazard Vulnerability Analysis Worksheet Emergency Earthquake Snow storm Mass Casualty Terrorism Worker Strike Civil Disturbance Contaminated Victim Infant Abduction Electrical Generator Failure Tornado Patient Care Services Impact on Services and Internal Resources Support Services Staffing Structure Utility Services Impact on External Resources Public Services Commercial Resources Staff Family Members total impact factors Risk Impact Criteria 0 No impact 1 Minimal risk of impact 2 Moderate risk of impact 3 Significant risk of impact 4 Severe risk of major disruption or impact SMS, Inc,,
33 Priority Ranking Strike Emergency Snow Storm Mass Casualty Generator Failure Tornado Score Rank SMS, Inc,,
34 I Emergency Initiation Process Incident Community Data AOD Hospital Data Stand-by Alert Initiation No Alert Normal Operation ACTION ALERT Emergency Operations Plan Specific Hospital Emergency Response Plans (Based on HVA) Severe Weather Plan Utilities Plan Mass Causality Plan Contaminated Victim Plan Civil Disturbance Plan Chemical Spill Plan Departmental Emergency Response Plans Examples Engineering Environmental Services Security Emergency Room Human Resources Nursing Services SMS, Inc,,
35 Emergency Management EC.4.10 EC Notification of staff Overhead announcement of Codes Call trees Pager list Intra-net net network Off Duty Pager, Cell phone, & Public announcement SMS, Inc,,
36 Emergency Management EC.4.10 EC Identifying & assigning staff to cover all functions ICS for each response plan Job Action Sheets (JAS) for major players SMS, Inc,,
37 All Hazard ICS for Healthcare Incident Commander Liaison Safety Public Information Medical Director Operations Logistics Finance Planning First responder Support responders Document and fund Information activities SMS, Inc,,
38 Emergency Management EC.4.10 EC Processes for managing Care & treatment activities Staff support activities Staff family support Critical supply logistics Security Communication with media Communication with patient SMS, Inc,,
39 Emergency Management EC.4.10 EC Order of removal Staff Equipment Staging areas Facility evacuation (horizontal & vertical, non-fire!) SMS, Inc,,
40 Emergency Management EC.4.10 EC Isolation & decontamination procedures for: Radioactive Biological Chemical SMS, Inc,,
41 Drill Preparation Process EC.4.20 HVA Committee Review Emergency Operations Plan Emergency Response Plan Departmental Response Plan Critique Exercise SMS, Inc,,
42 Managing Fire Safety Risks EC.5.10 EC Develop of fire response plan Facility-wide fire response Area specific needs including evacuation routes Roles & responsibilities at fire scene Roles & responsibilities away from fire Roles & responsibilities in building evacuation SMS, Inc,,
43 Managing Fire Safety Risks EC.5.10 EC Reviewing acquisitions of relevant items (e. g., bedding, draperies, furnishings, decorations) SMS, Inc,,
44 Managing Medical Equipment Risks EC.6.10 EC Process for selecting & acquiring medical equipment SMS, Inc,,
45 Managing Medical Equipment Risks EC.6.10 EC Development of emergency procedures Equipment failure or disruption Emergency clinical interventions Availability of back-up equipment Obtaining repair services SMS, Inc,,
46 Maintaining, Testing & Inspecting Medical Equipment EC.6.20 EC Documenting performance testing of all sterilizers SMS, Inc,,
47 Maintaining, Testing & Inspecting Medical Equipment EC.6.20 EC Documenting chemical & biological testing of water used in renal dialysis SMS, Inc,,
48 Managing Utility Risks EC.7.10 SMS, Inc,,
49 Maintaining an Appropriate Environment EC.8.10 EC Furnishings & equipment in good repair & appropriate to patient needs SMS, Inc,,
50 Maintaining an Appropriate Environment EC.8.10 EC Outside areas appropriate & safe SMS, Inc,,
51 Maintaining an Appropriate Environment EC.8.10 EC Areas used by patients clean, safe, comfortable, functional SMS, Inc,,
52 Maintaining an Appropriate Environment EC.8.10 EC Lighting suitable for activities SMS, Inc,,
53 Maintaining an Appropriate Environment EC.8.10 EC Ventilation appropriate (humidity, temperature, odors) SMS, Inc,,
54 Building design EC.8.30 Importance of the EHS professional becoming a stakeholder in the Building Design & Construction process Using established guidelines (e. g., AIA, State) Proactive risk assessment (construction, renovation, or demolition) Assessing impact of construction on air quality, infection, utility systems, noise, vibration, & emergency procedures Selecting controls to minimize risk SMS, Inc,,
55 Pre-Construction Risk Assessment (PCRA) When planning demolition, construction or renovation, the hospital conducts a proactive risk assessment SMS, Inc,,
56 PCRA JCAHO-identified concerns Air quality (dust, temperature, humidity) Infection Control (mold, pathogens) Utility disruption (electrical, communication) Noise (sudden & long-term) Vibration (anywhere) Emergency Preparedness (internal & external) Interim Life Safety Measures (EC.5.50) SMS, Inc,,
57 PCRA Other Concerns Hazardous Materials (worksite inventory) Security (gates, fences, doors) Safety (staff, visitors, patients) Environmental Services (dirt, debris) SMS, Inc,,
58 PCRA Team Effort Design Team Infection Control & Epidemiology Facilities Management Safety & Security Environmental Services Contractors SMS, Inc,,
59 Measuring & Improving Activities Monitoring Conditions in the Environment EC.9.10 EC An accident & incident reporting process for all types of events Injuries Occupational illnesses Security incidents Hazardous materials & waste incidents Fire safety Equipment management issues Utility system issues SMS, Inc,,
60 Measuring & Improving Activities Monitoring Conditions in the Environment EC.9.10 EC An annual evaluation of the objectives, scope, performance, & effectiveness of the plans SMS, Inc,,
61 Measuring & Improving Activities Monitoring Conditions in the Environment EC.9.10 EC Integration of safety monitoring & response activities into the patient safety program SMS, Inc,,
62 Measuring & Improving Activities Analyzing & resolving Environment of Care issues EC.9.20 EC Multidisciplinary improvement team meets at least bimonthly to address EC issues SMS, Inc,,
63 Measuring & Improving Activities Analyzing & resolving Environment of Care issues EC.9.20 EC Analyzing EC issues in a timely manner issues SMS, Inc,,
64 Measuring & Improving Activities Analyzing & resolving Environment of Care issues EC.9.20 EC One or more performance improvement activities is communicated at least annually to Leadership based on the ongoing monitoring of performance of the EC management plans SMS, Inc,,
65 Preparing for Survey Inform staff of survey process Practice answering staff knowledge questions Be friendly to all visitors Maintain the facility at a level acceptable for survey Participate in the Environment of Care process SMS, Inc,,
66 SMS, Inc,,
How To Understand The Safety Management Program
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