Fit-testing woes may trace back to financial aloofness
As a function of the respiratory protection standard, OSHA requires annual fit-testing for folks whose occupational exposure risks indicates the use of respirators. In the past, OSHA was prohibited from enforcing that aspect of the standard, largely in response to pleas to Congress from the various and sundry state, regional, and national hospital groups.
So, effectively, there was a grace period for hospitals. This did very little, if not nothing, in the way of preparations for 2008’s change of position, when OSHA and Congress decided to start enforcing the fit-testing requirements.
Hospitals are absolutely struggling with this. Some continue to struggle with initial fit-testing requirements, never mind having to deal with any recurring frequencies. In analyzing the financial impact of this requirement on hospitals (and, to be honest, I don’t recall the exact figure), there is some sense that perhaps the data used was more modest in nature than practice would bear out.
I suspect it has a lot to do with the fact that hospitals weren’t really in compliance to start with, so when these same hospitals were surveyed by the government and associations to determine likely increases in financial burdens, it seems very possible (maybe leaning all the way over into probable) there was an assumption that they were already in compliance with the incoming testing.
About the Author: Steve MacArthur is a consultant for The Greeley Company, a division of HCPro. He brings 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at 
