Industry Update - July 2019
by Joe Brothman, Director, EHS & EM, UCI Health
Click here to access the full PDF version of this month's update.
Parts of a hospital in Ridgecrest were evacuated after a magnitude 6.4 earthquake shook the region on the 4th of July. 15 people were transported from Ridgecrest Regional Hospital after the earthquake struck at 10:33am. The epicenter of the quake was about 11 miles northeast of Ridgecrest. The hospital experienced structural damage, including some leaking sprinklers. Patients were evacuated to a facility in the Palmdale-Lancaster area.
Facilities should have a planned survey route that is developed during survey planning and audited during internal mock audits. This building tour guidance document will aid facilities managers prepare for accreditation surveys. This Health Facilities Management article provides more detail on best practices to prepare for surveys.
“Seattle Children's hospital has reopened 14 of its operating rooms after one patient died and five others developed an infection from mold following surgical procedures over the last two years. The hospital closed the operating rooms in May after routine testing detected aspergillus in several ORs and in equipment storage areas. The closure resulted in roughly 1,000 surgeries being moved to other hospitals, according to NBC affiliate King5 News in Seattle. The operating rooms reopened Thursday after the hospital deep-cleaned the rooms, upgraded its air handling and purification systems, and installed a new humidification system.”
USGBC created the LEED green building program to measure and define green building and to provide a roadmap for developing sustainable buildings.
In April 2019, USGBC officially released the complete suite of LEED v4.1 rating systems. LEED is updated through a continuous improvement process and with each new version USGBC is evolving LEED's approach and challenging the building sector to be more resource efficient and sustainable.
The U.S. Green Building Council (USGBC) announced a call for proposals to solicit feedback and concepts for the next version of LEED. Comments and feedback are being accepted at usgbc.org/leed. Based on feedback, USGBC will host a session at Greenbuild in November to provide updates to the program.
The performance of hazard surveillance rounds, as it relates to indoor air quality (IAQ), provides a key opportunity to identify IAQ issues. ASHE's “Indoor Air Quality Checklist Tool” can be used to supplement hazard surveillance rounds and incorporate items related to IAQ.
In response to the Occupational Safety and Health Standards Board's decision on February 15, 2018 to grant Petition No. 567, the Division of Occupational Safety and Health (Cal/OSHA) will convene an advisory meeting to consider development of a rulemaking proposal to protect employees from surgical plume and smoke. Cal/OSHA is holding an advisory meeting in Oakland. At this advisory meeting, stakeholders and the public will have an opportunity to provide input on information and scientific data on surgical plume and smoke hazards, control measures, feasibility, or costs. A discussion draft, meeting agenda and additional meeting documents are provided on the Cal/OSHA website.
Facilities & Engineering Week will take place October 20–26, 2019. To celebrate, ASHE will be hosting two free members-only webinars as well as a social media contest. Perhaps sharing this ASHE endorsed video will liven up your week!
The Joint Commissions DAILY UPDATE page recently highlighted many topics in an effort to clarify ligature reduction strategy questions. Some of the topics include dropped ceilings in corridors and common areas, video monitoring, inpatient psychiatric unit height requirements, emergency department guidance, shower curtains, and more.
The California Building Standards Commission has announced the availability of the 2019 California Building Standards Code, which takes effect Jan. 1, 2020. The 2016 Building Standards Code remains in effect until Dec. 31, 2019.
The California Building Standards Code is found in Title 24 of the California Code of Regulations. The 2019 edition will be published on or before July 1 and is currently available for purchase from the International Code Council, the International Association of Plumbing and Mechanical Officials, or the National Fire Protection Association.
The ASHE 2019 elections are now open! Cast your vote for Associate Member Representative and Region 3, 6, 7, 8, & 10 Board Members. The candidates seeking office are shown below. The election for the next president-elect is postponed as ASHE’s National Nominations Committee could not secure two candidates for president-elect. ASHE will continue to update members on this issue. ASHE membership is required to cast a vote.
Click to vote online from July 19th through August 5th.
On Aug. 21, 2019, the Environmental Protection Agency’s (EPA’s) Final Rule: Management Standards for Hazardous Waste Pharmaceuticals and Amendment to the P075 Listing for Nicotine will begin impacting how hazardous waste pharmaceuticals are managed in hospitals and other health care facilities. .
An effective preventive maintenance work flow should begin from the beginning of a construction project. ASHE’s “Construction to Maintenance Work Flow Tool” provides a diagram to help ensure that preventive maintenance operations are ingrained into the building of new facilities.
The American Society for Health Care Engineering’s (ASHE) Career Collaboration Project explored gender differences. Results indicated that men taking the survey were, on average, five years older than women. Educational attainment was similar across both genders, and no differences were found for career satisfaction or career satisfaction social comparisons. A few significant gender differences were found. First, women reported earning less than their male counterparts. Second, number of years in the career field was found to significantly predict salary (meaning that as number of years in field goes up, salary goes up) for men, but not for women. This feeling must at least be partially felt by women respondents because women were much more likely than men to report salary social comparisons indicating that they felt they earned “much less” or “a little less” salary. These results could suggest that as the field continues to see an increase in female representation and career development over time, it may expect to see a closing of gender-related gaps and in women’s negative social comparisons related to salary equity in the future.
The National Fire Protection Association (NFPA) membership voted on a new standard at last month’s NFPA Conference & Expo in San Antonio. NFPA 855, Standard for the Installation of Stationary Energy Storage Systems, covers the design, installation and operation of alternative power sources, including combined heat and power (CHP) and microgrid systems. CHP and microgrids are increasingly a focus of ASHE members because of the continual need within health care facilities to improve energy efficiency while reducing carbon emissions, enabling health care facilities’ finite financial resources to be stretched further
The aim of USP 800 is to protect health care workers and patients from harm associated with exposure to hazardous drugs (HDs). According to the Centers for Disease Control and Prevention (CDC), eight million health care workers are potentially exposed to HDs every year. This exposure can occur with workers who are unaware of their exposure and in departments outside of the pharmacy. USP 800 was developed to define the quality standards for the handling of HDs and the proper environmental controls for compounding to protect health care workers and patients. Aspects of handling HDs covered in USP 800 where exposure can occur include receiving, transporting, storing, compounding, dispensing, administering, spills, cleaning and waste disposal. Entities that handle HDs must incorporate the standards in chapter 800 into their occupational safety plan. The plan’s health and safety management must, at a minimum, include:
- List of HDs
- Facility and engineering controls
- Competent personnel
- Safe work practices
- Proper use of appropriate Personal Protective Equipment (PPE)
- Policies for HD waste segregation and disposal
This American Society for Health Care Engineering (ASHE) monograph discusses the physical environment provisions of USP 800 and is primarily intended for the use of health care facility managers. The USP 800 Risk Readiness Checklist, created by the American Society for Health Care Risk Management (ASHRM), will assist users in identifying areas where opportunities exist to comply with USP 800 required standards.
Cal/OSHA recently adopted an emergency rule applying to workers affected by wildfire smoke. It applies to workplaces where the Air Quality Index (AQI) reaches 151 – unhealthy – and when employers “should reasonably anticipate” that employees may be exposed to wildfire smoke. Exempted are indoor workplaces and enclosed vehicles with filtered air, firefighters engaged in wildland firefighting, and employees with short-term exposure to the foul air (no more than one hour). Employers are required to monitor worksites during fire season to check for particulate matter 2.5, the pollutant of concern. If the air quality is measured to be out of range, employees will need to be moved to an indoor location with filtered air or to a location where the AQI is below 151. If relocation is unreasonable, workers must be provided with respirators, such as N95s, for voluntary use. Only in extreme situations with an AQI above 500 will mandate respirator use for employees. Workers must also be trained on the new regulation and with new equipment being mandated by the regulation.