Always read and follow the instructions
While I sometimes like to think that, one day, the substantial focus on the management of the physical environment will be recast in the direction of clinical practices and processes, I know (in my heart of hearts) that as complicated an undertaking as clinical care is, the management of the environment is the foundation for everything else. For example, if the infection control risks in the environment are not appropriately managed, then clinical care will be negatively impacted. Or, if safety risks are not appropriately managed, again, clinical care is impacted. The environment and care are inextricably linked, and always will be. And, as the calls increase for regulators to survey all care environments, it becomes even more important to be as diligent as possible in ensuring that your practices and processes for managing each of those environments is as standardized as you can make it.
But what about services that are contracted out, particularly those relating to the cleaning and maintenance of healthcare facilities? Do you have an oversight process that will ensure consistency of approach and, by extension, consistency of results? Are you making sure that contracted cleaning staff are using chemical disinfectants in accordance with the manufacturers’ instructions for use? Are those folks using appropriate personal protective equipment as outlined in the safety data sheets for the products? (If you’re interested, here’s a good read on how one can move toward reducing the reliance on PPE use—don’t forget to consider risk mitigation and abatement.)
As with any risk management undertaking, there is always the potential for a risk assessment, but in areas that are not “directly” under your control, you probably want to have the assessment in place before you start any new process, including adding new contractors to the mix. It’s really an important part of the process for onboarding new products, practices, etc. Unfortunately, humans have an enormous capacity for doing things you might not have anticipated, so you want to try to give them as much structure as possible. They also need a reliable and accessible way to ask questions. If folks don’t understand something, you want to make it easy for them to get the information from the right people. Without an effective communications process, you exponentially increase the risk of “unauthorized field modifications” (you may know them as “workarounds”), and if those modifications occur in environments in which you don’t have constant oversight, they have a nasty habit of making themselves known during surveys. Keeping everyone on the same compliance page can be the work of a lifetime—and a constant effort at that, but everybody doing the same thing the same way is the end game!
About the Author: Steve MacArthur is a safety consultant with The Chartis Group. 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 an advisory board member for Accreditation and Quality Compliance Center. Contact Steve at stevemacsafetyspace@gmail.com.