Preventing CMS readmission fines due to Healthcare-Associated Infections (HAI’s)-Part IIIa-Ventilation

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Randy CharpentierIn part IIIa of my blog series regarding the CMS report on fines issued to hospitals for having too many patients return within a month for additional treatments  I’ll focus on Indoor Air Quality and ventilation systems as a primary driver in preventing HAI’s and will present challenges and opportunities to assist healthcare executives in addressing this key component. In order to do this it is important to have a basic understanding about ventilation systems.  (Blogseries IntroPart I-Hand Hygiene, Part II-PPE)

Healthcare Ventilation is Complex

Indoor air quality has been a hot topic in healthcare for many years, and has presented many challenges to industry leaders, facility architects, hvac design/mechanical engineers, construction/renovation firms, facility directors and maintenance managers with solving the constant changes in system design and proper management of the environment of care in today’s healthcare world. A healthcare ventilation system is an integral component in combatting HAI’s and one of the most complex to manage.

With all of the internal components like:

  • fresh air intake and make up air (location)
  • heating/cooling mixing chambers
  • filtration banks
  • coil compartments, condensate drip pans
  • humidification processes
  • supplemental cooling and heating systems (VAV’s, FCU’s, Reheats, Inline Coils)
  • turning vanes, dampers
  • diffusers, registers
  • Temperature, relative humidity regulating
  • Fiberglass insulation (Internal/External)

….it’s no wonder that these systems require constant attention. 

The demand on these systems to supply & maintain proper temperature, relative humidity, manage air pressure relationships and provide the proper volume of fresh/recirculated conditioned/exhausted air, filter external/indoor air contaminants while producing energy savings is a constant juggling act.

Why is Ventilation Important?

  • Ventilation systems are an integral part of all healthcare/hospital facilities. They are designed to be energy efficient and keep occupants/patients comfortable with heating and cooling of the physical environment, filter particulates i.e. dust, pathogens/biological contaminants, continuously circulate or remove fresh and/or filtered air, and control /reduce/ eliminate nuisance/obnoxious odors.
  • Most facilities are engaged in energy management systems (Building Automated Systems/BAS) that are designed to maximize energy efficiency/capture cost savings when feasible and/or when spaces are unoccupied/under or not utilized as intended. The ventilation system is not an area that should be targeted for cost savings by shutting down or reducing air flow as they are too important in combatting HAI’s.
  • Ventilation rates are now the hot button item for any facility targeted for a Joint Commission survey as the surveyor will examine air exchange rates and pressure differentials for O.R.’s, ICU’s, Special Procedure, Isolation Rooms, designated Clean and Dirty spaces like utility and linen closets.

In my next post, (Part IIIb) I will break down the variables involved with how a ventilation system can play a major factor in combatting HAI’s. Describe the various roles and challenges of key stake holders from the design phase, to installation, commissioning, testing, certifying, balancing and proper maintenance to achieve optimum performance for the comfort and safety of patients, staff, visitors who depend on the Environment of Care for their well being.

Randall Charpentier is a 20 year experienced, safety and risk management consultant specializing in healthcare compliance and best practice management. Project experience ranges from leading teams on the construction of the west coast space shuttle project, working internationally & domestically for leading environmental engineering firms conducting real estate assessments involving occupational and environmental risks, assessing business operational risks concerning commercial insurance policies, and reducing/eliminating exposures/hazards, to leading world renowned, top ten/one hundred community based & BioMedical Research/Teaching hospitals, with development and execution of best practices with EOC, Fire/Life Safety, Infection Prevention in Healthcare Construction, and Emergency Management programs.  HSNE’s/Randall’s passion is keeping patients, staff and visitors safe in a healthcare setting.  CMS is measuring safety and quality in healthcare facilities basing reimbursement on healthcare outcomes. Does your facility measure up? If not, you should conduct a risk assessment. Is your facility compliance or results driven? To find out, contact rcharp@hsnellc.com or www.hsnellc.com, or LinkedIn profile.

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