to main content Answering Your Physical Environment Questions | The Joint Commission
Leading Hospital Improvement

News and knowledge targeted for the hospital environment.

Answering Your Physical Environment Questions


By Herman A. McKenzie, MBA, CHSP, director of engineering, Standards Interpretation Group

These past five months have been extremely challenging for all of our accredited organizations, as we combat a pandemic that is unprecedented in our lifetime. In every type of health care setting, there is widespread recognition that the health care physical environment plays a crucial role in preventing the spread of infectious disease, as well as many other hazards.

During these difficult times, my team In the Department of Engineering, Standards Interpretation Group, has been busy fielding numerous questions regarding The Joint Commission’s Environment of Care (EC), Life Safety (LS), and Emergency Management (EM) standards. We have posted the most frequently asked questions—and their answers—on the “Interpreting Joint Commission Standards: FAQs” pages of our website.

Since April, we have added or updated FAQs on the following wide-ranging topics, among others: 

  • the placement of handwashing sinks in outpatient settings
  • emergency clinical interventions during utility system disruptions
  • utility system maps
  •  managing clean versus hazardous waste
  • the placement of alcohol-based hand rub (ABHR) dispensers in waiting areas
  • hazard vulnerability analysis
  • granting disaster privileges

If you have questions about these topics or any others, please visit the FAQ site. If your question is not answered on the site, click on “Standards Interpretation Group (SIG)” and follow the directions on the Standards Online Submission Form.

Complex Utility Systems
Utility systems in health care facilities are especially complex, so it’s not surprising that this realm is well represented in the FAQs. 

In fact, EC.02.05.01—"The [organization] manages risks associated with its utility systems”—is one of the top-cited standards for noncompliance. Survey data for full-year 2019 revealed that the most commonly scored high-hazard physical environment requirement for ambulatory health care facilities and hospitals (including critical access hospitals) pertained to the need to control airborne contaminants (such as biological agents, gases, fumes, dust) through ventilation systems that provide:

  • appropriate pressure relationships
  • air-exchange rates
  • filtration efficiencies
  • relative humidity
  • temperature 

To be sure, hospitals and other types of health care facilities with superior ventilation management are best positioned to weather the COVID-19 crisis. 

Beyond our FAQs and your Comprehensive Accreditation Manual (or its E-dition counterpart), another valuable source of information on utility systems—and other aspects of the health care physical environment—is the 3rd edition of EC Made Easy: Your Key to EC, EM, and LS.  Published by Joint Commission Resources (JCR) during the early months of the pandemic, this book may have escaped your notice as you were battling the first surge of SARS-CoV-2. 

If you are new to facilities management or accreditation, you’ll find this book especially helpful. Through all of our resources, from our publications to our webinars and, of course, through the survey itself, we want to assist you in creating an environment that optimizes health care quality and patient safety.

Herman McKenzie is currently the director, Department of Engineering in the Standards Interpretation Group at The Joint Commission. Mr. McKenzie has more than 25 years of health care experience having held managerial and director level roles in clinical engineering, plant operations and facilities services throughout the Chicagoland area. He was part of the team that opened the first new hospital in Illinois in over 25 years.