Environment of Care (EC) (Critical Access Hospitals / Critical Access Hospitals)
Pre-construction Risk Assessment - Requirement
Publish | January 01, 0001
What is the requirement for an organization to have a pre-construction risk assessment?
Standard EC.02.06.05 requires the organization to have a pre-construction risk assessment process in place, ready to be applied at any time if planned or unplanned demolition, construction or renovation occurs. The assessment covers potential risks to patients, staff, visitors or assets for air quality, infection control, utility requirements, noise, vibration and any other hazards applicable to the work. The Joint Commission does not dictate a particular risk assessment and implementation process. Recommendations can also be found in the 2010 FGI Guidelines for Design and Construction of Health Care Facilities and the Centers for Disease Control and Prevention (CDC). Recommendations and guidelines are not requirements unless adopted by a controlling authority. Many organizations use an assessment matrix that applies the construction intensity to the risk level of the work area, which results in particular protective practices to be implemented or an available menu of protective practices to be implemented. Also, it is acceptable to implement policies that allow for minor work tasks to be performed in established locations or under particular low risk circumstances using predetermined levels of protective practices. This could include removing ceiling tile for inspections, control device operation, minor repairs, etc. The area of the work would likely dictate the level of unprotected work allowed, for example, an lower risk administrative or support services area versus a high risk sterile or critical care area. Staff and contractors performing the work are to have working knowledge of the established criteria, to include why protective measures are necessary. Some organizations choose to use a permit process, particularly when contractors are performing work in their facilities, where for example, permits are prominently displayed on their ladder or work area. It is recommended that occupant staff be aware of the general work guidelines, particularly when using a permit process, in order to provide extra enforcement capability. Pertinent work practices are to be used such as spraying ceiling tile with a liquid before removal, having a portable vacuum or wet cloth handy when removing electrical covers, or using containment booth when working above the ceiling at an isolated location. Again, the task and the location of the work would dictate the level of protection, if needed. The definition used for demolition, construction or renovation is less important than the context of the work. Will the work result in an environmental risk to patients, staff or visitors? Again, there can be policies in place to manage regular inspection, maintenance and repair activities, with an assessment process established for more complex or unusual activities. That assessment process can range from pre-established practices to situations that require extensive analysis. [EC.02.06.05]
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