Four ways the EC chapter improved your job

Hospital Safety Insider, March 24, 2016

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The year 1995 was pretty busy. Operation Desert Storm in Iraq officially came to an end, the Murrah Building in Oklahoma City was bombed on April 19, "Superman" actor Christopher Reeve was paralyzed in a horse riding accident in May, and The Grateful Dead played their last concert on July 9.

It sounds like a lot of doom and gloom, but 1995 also featured a development that improved the jobs of many hospital safety professionals lucky enough to have had their jobs 20 years ago, and for that matter, made patient care and safety in hospitals that much better.

The year 2015 is in many circles considered the 20th anniversary of The Joint Commission's Environment of Care (EC) standards chapter, which focused on the safety of the physical environment of hospitals and made them more accountable for keeping facilities safe. Since then, violations of EC standards, along with those from the emergency management (EM) and life safety (LS) chapters, have consistently made the Top 10 list of violations most cited by surveyors when inspecting the nation's hospitals. Of course, there are many different interpretations of what makes a hospital compliant, and many an argument, as well as a violation challenge, has started over different interpretations of things from fire doors to emergency plans to routes of egress.

Whatever your take, the EC chapter changed your job forever, and here's the four most important of those changes.

The standards were made to be changed.
At its core, the EC chapter, and the Joint Commission standards, for that matter, was designed to help make hospitals a safe place for patients, not really to make your job more difficult. But perhaps one of the best things about the standards you follow is that they are adjustable as conditions warrant, and you would be a proactive healthcare safety professional to keep up on those changes. For an example, Susan McLaughlin, MBA, FASHE, CHFM, CHSP, managing director of MSL Healthcare Consulting Inc., Barrington, Illinois, and a former associate director of standards interpretation at The Joint Commission, wrote in a March 2014 article in Health Facilities Management magazine about important changes to the EC and EM standards. Among them was a change to the EC Chapter, Element of Performance (EP) 11, regarding hazardous materials. In the change, the term MSDS is changed to SDS, a small but very important change to keep facilities in line with the new OSHA GHS requirements for chemical labeling.

It made things easier to understand. This is a subjective observation, as there are plenty of people out there who will disagree and tell you the Joint Commission standards are confusing. We won't argue that the standards are complex, and much of the language is vague. But what it definitely did was break things out piece by piece so that you have a better understanding of what is required. Because of the 1995 EC chapter, its subsequent updates, and the advent of the EM and LS standards, you have what amounts to a bulleted list of what's required of you. It's a lot to follow, but it's written in plain language for you.

It made hospitals more accountable.
There's a good chance you're pretty familiar with this, because the EC standard gave you a lot more paperwork to keep track of every year. That's exactly how The Joint Commission planned it. By collecting information, The Joint Commission made sure that hospitals have information they can use, not only to keep facilities on their toes, but more ideally to help them improve their level of service.

Out of the EC chapter came the Life Safety and Emergency Management chapters, which carried with them their own requirements of accountability, and paperwork. Thank these standards for the Hazard Vulnerability Assessment, your detailed emergency plans and drill requirements, and your fire alarm and fire door testing requirements that you endure annually. Not to mention the paper trails that inspectors rely on and expect when they come to survey your facility.

It encouraged teamwork.
The EC standard, and the division of seven EC "functions" (safety, security, hazmat, emergency, life/fire, medical equipment, utility systems), led to the creation of multidisciplinary teams in hospitals that work together to accomplish the same goal, which is to keep the facility safe. To ensure that hospitals meet strict Joint Commission standards, hospital safety personnel cannot work in a vacuum, and the most proactive rely on their nurse supervisors, infection preventionists, maintenance, security directors, and other personnel to help keep their respective areas compliant.

This is an excerpt from the monthly healthcare safety resource Briefings on Hospital Safety. Subscribers can read the rest of the article here. Non-subscribers can find out more about the journal, its benefits, and how to subscribe by clicking here.


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