October 06, 2015 | | Comments 0
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After all these years, it’s true: Your mother doesn’t work here

Over the years, once or twice I’ve ventured into staff areas as I’ve toured various facilities—sometimes you find some things that are a little disconcerting (electric grills, various electric food-preparation appliances), but sometimes you find things that can bring a little levity to the moment. One of the time-honored postings is a variation on that old saw “Pick up your mess, your mother doesn’t work here.” While I know that is not always a factual statement (my mom worked at the same hospital as I did for rather a while, though she was not particularly keen on cleaning up messes in either place), I think there is a grain of something that is instructive in how we need to move forward in the management of the physical environment. It all ties back to the finder/fixer dynamic that can work so very efficiently when you get enough participation, with a little bit of incident command tossed in for good measure. Ideally, the level of response to any condition would be in direct proportion to the resources needed to resolve that condition, with the thought being that whoever first identifies the condition is thus “in command” of mustering those resources. So, a paper towel or a plastic bag or some other debris on the floor becomes the point of contact relative to that response. My personal philosophy in this regard (and I apologize if I’ve spouted off on this in the not-distant-enough past) is that if I encounter a condition that I can resolve by my own actions, then that is my obligation. I am no big fan of leaving things for others to do, and I know that tendency exists to one degree or another in most people (I know better than to think everyone is so inclined), but the question I keep asking myself is: How do we get folks to act on it? Someone’s walking along with a cafeteria tray and a napkin blows off the tray—there are thems that will stop and pick up the napkin and there are thems that do not. I guess the overarching question is whether or not it is foolish to think that we can get batter at this, but doggone it, don’t you think we should be able to? Oi!

On a completely unrelated note, word came down from Mount TJC last week that a new module has been uploaded to the Environment of Care portal dealing with that even more time-honored undertaking, the integrity of egress. In looking over the materials (and I encourage you to do so as well—it won’t take very long), the focus appears to be corridor clutter and the locking of doors in the path of egress. Now, the example given on the portal page indicates that it is an example of improved compliance for EP 1 (locked egress doors) and EP 13 (corridor clutter), but the example seems to be a rather odd confluence of discussion points. Both topics are addressed, for sure, but I’m not entirely certain how instructive this is, particularly the piece about locked doors. Maybe you folks see things differently; I’d love to get your feedback.

That said, one thing I noticed was missing (can you really notice something missing?) was no coverage of findings related to Exit and NO Exit signs—maybe some sense of how you can evaluate your facility in this regard. It seems to me that I’ve encountered a slew of findings relating to egress signage (more not having NO Exit signs than not having enough exit signs), including concerns with non-compliant signs (for example, the 2000 Life Safety Code® has very specific instructions relative to NO Exit signs: “7.10.8.1 No Exit. Any door, passage, or stairway that is neither an exit nor a way of exit access and that is located or arranged so that it is likely to be mistaken for an exit shall be identified by a sign that reads as follows: NO EXIT Such sign shall have the word NO in letters 2 in. (5 cm) high with a stroke width of 3/8 in. (1 cm) and the word EXIT in letters 1 in. (2.5 cm) high, with the word EXIT below the word NO.” ). It just seems to me that there could be a little more information to help organizations better prepare their facilities for inspection, but also (and in my mind, this is rather more important) provide a safer care environment. Maybe I need to adjust my expectations on this process…

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Filed Under: CMSEnvironment of careHospital safetyLife Safety CodeThe Joint Commission

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 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 stevemacsafetyspace@gmail.com.

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