Mac’s Safety Space: To be or not to be—that is the risk assessment!
A couple of fairly short (and somewhat disparate, but the risk assessment process can figure in both) items this week: one a question/thought relating to emergency management and the impact of behavioral health patients on evacuation and the other relating to the fine art of interpretation.
First up, as there have been a few instances recently of full facility evacuations, it occurred to me that there would be a fair degree of difficulty if one had to evacuate/urgently relocate patients who might be at active/heightened risk for self-harm. My questioning revolves around how much pre-planning folks have done as a function of ligature-resistance in what I will collectively identify as alternate care sites (or locations – your choice).
I am often asked about how much needs to be assessed for risk (which has been a recurring question for the last decade or so) and the response I keep giving: any risk that cannot be completely abated and is of moderate or significant risk (fully recognizing that there is a wee bit of assessment involved to get to the point where that determination can be made—it is rather much like a snake consuming it’s tail—small pun intended).
At any rate, for those of you who have behavioral health patients in the mix, how much planning for relocation, including evaluation of the “destination,” have you memorialized? How many different locations have you identified, if your situation requires the use of more than one spot and how in-depth has been your evaluation of the proposed spaces? If anyone is inclined to actually respond in real time, please feel free to reach out to me directly at stevemacsafetyspace@gmail.com—I would appreciate any sense of what your approach(es) have been.
Item No. 2 relates to the ongoing influence of the Facilities Guidelines Institute’s (FGI) Guidelines for the Design & Construction of health facilities documents (almost too many to count—you should definitely have some in your library). As something of an independent authority (lots of authority, not so much jurisdiction except in the hands of others), FGI is always looking to support the healthcare industry in making the wisest possible choices for design and construction considerations, including managing a process for requesting official interpretations.
If you have a chance, I would really recommend checking out FGI’s interpretations homepage (https://fgiguidelines.org/guidelines/interpretations/). Not only do they outline the process for requesting an official interpretation, but the page also includes links to archived interpretations, including the latest guidance on bathroom floors in aII rooms (they recommend having the same type of flooring as the rest of the room, including the anteroom).
As with so many things that we’ve discussed in terms of available resources, the information is accessible to everyone, including the authorities having jurisdiction (AHJs). Don’t get caught out because you missed an interpretation—check out the homepage and sign up for the newsletter—you’ll be glad you did! Who knows, these interpretations might come in handy when you’re penning your next risk assessment…
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.