Improving Processes to Reduce HAI Risk
Engineering the HAI risk out of healthcare facilities through optimum environmental, workflow and material design will realize their bacteria-fighting potential only if the right processes and procedures are in place to support them, according to several members of our panel of experts. Put simply, it doesn’t matter where the hand sanitizers or medical waste bins are located in a patient’s room if no one is washing their hands or taking out the garbage.
At the top of the proper processes and procedures list for Tony Shadix is the adequate cleaning and disinfecting of reusable medical supplies, devices, equipment and surfaces at a hospital or health system. Shadix is a JLL vice president and assistant operations director at Adventist Health. Failing to follow proper cleaning and disinfecting procedures can result in the spread of infection-causing bacteria from one patient to another.
Maintaining and monitoring the performance of mechanical functions designed to mitigate the risk of infection also should be a high priority of hospitals and health systems. Examples include replacing air filters at the recommended frequency, ensuring a minimum of 24 air exchanges per hour in operating room suites, maintaining the proper positive air pressure in operating room suites and maintaining the proper temperature and humidity levels in patient care areas.
Hospitals and health systems should have manual or automated systems to check, record and report performance data to facility managers who, in turn, should review that performance data to make any necessary repairs or adjustments to avoid environmental conditions that could promote the spread of HAIs in their facilities.
Controlling Infections by Controlling Contractors
Many hospitals and health systems outsource facilities or plant management functions to outside contractors and vendors. Among those functions are HVAC (heating, ventilation and air conditioning) services, janitorial services and building maintenance. All are essential to the successful operation of a healthcare facility, yet all are potential sources of HAIs and spread of HAIs.
Consequently, it’s important for hospitals and health systems to actively monitor and manage the adherence by outside contractors to their infection control policies, say members of our panel. If you don’t know who is coming in and out of your facility to do work
on a daily basis, you have a huge gap in your infection-control program, says Sydney Scarborough, managing director at JLL Healthcare Solutions.
Hospitals and health systems can fill that gap by including specific terms in their contracts with outside contractors and vendors. First, the contracts must specify that the expected level of service matches your infection control parameters. The frequency of air or water filter changes at hospitals and health systems is different from that at hotels. Second, the contracts must require outside contractors and vendors to follow recommended maintenance procedures for equipment to make sure it’s performing the way it should to prevent the spread of bacteria.
Hospitals and health systems also should require contractors who are doing temporary construction, renovation or repair work at their sites to follow infection-control guidelines. That means adhering to such guidelines as hand-hygiene protocols, vaccination and immunization requirements and protective mask, glove, gown and shoe cover rules. A good working relationship between a hospital’s lead infection ‘preventionist’ and the hospital’s facilities management director, whether that person is in house or outsourced, is essential to reducing the risk of infection from outside contractors and vendors.
Infection Control Starts at the Top
Facility design, operations and management all represent powerful opportunities to reduce the rate and spread of HAIs. Taking advantage of those opportunities, though, depends on culture, and culture starts at the top of a healthcare organization, according to Marsha Barnden, corporate director for infection prevention and clinical standards at Adventist Health.
Facilities managers and infection control leaders, in turn, must share what they know with each other and with the C-suite. Working together, administrators, facilities managers and infection-control specialists can use facility design, operations and management as powerful weapons in the fight against HAIs.