March 24, 2020 | | Comments 0
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Time I had some time alone: How negative do we need to be?

Just a quick couple of items this week. Don’t want to take you too far away from your primary focus!

First up, I’ve been working with some folks for whom there’s been something of a disconnect relative to the general concept of a room being under negative pressure versus an Airborne Infectious Isolation (AII) room. While all AII rooms are negative, all rooms under negative pressure (and there is a certain inescapable logic to this) are not AII rooms. It would seem that there are clinical folks that use the terms interchangeably (albeit in good faith) and sometimes, for example, when reporting isolation capacities to authorities, that interchangeability could put people at risk. Fortunately, the current state of affairs with COVID-19 does not require the use of AII rooms for holding patients, but it’s probably a good time to make sure that everyone is on the same page relative to your organization’s “true” isolation capabilities. It’s probably also a good time to keep a close eye on performance of these spaces—current events really highlight the need to be sure of which way the wind is blowing in your critical spaces.

For further reading, you might find the following information useful:

  • This Compliant Healthcare Technologies blog post covers some of the particulars relating to negative pressure considerations; might be familiar territory, but a refresher never hurts.
  • This Stericycle article covers some of the particulars relating to the management of waste during the current conditions; a lot of useful information from my perspective and perhaps yours, too.

As a final note, I suspect there’s been a fair amount of discussion in the background as to how the current state of emergency is going to impact the survey process once it re-emerges from the swamp. Right now, it’s not clear if any of the existing waiver processes is going to result in any flexibility relative to the various and sundry compliance activities that might be delayed, particularly those activities for which you’ve contracted with external vendors (fire alarm and sprinkler system inspection, testing and maintenance being a good example). At this point, it’s anyone’s guess, but past survey experiences in the aftermath of emergencies would seem to indicate that surveyors will feel bad about citing you for missing a timeframe (and will absolutely understand how it happened, etc.), but will still write the finding. I’ve been keeping a close eye on all the issuances from CMS, TJC, etc., and I haven’t seen anything relating specifically to all the stuff we worry about.

That said, my best advice at the moment is to document any compliance challenges manifesting themselves during this implementation of your emergency response plan and have a risk assessment for the impact on the life safety of building occupants in your back pocket, with perhaps some implementation of education initiatives, etc., to ensure nobody is put at an additional risk. Certainly, there are internal processes that could still be administered, but probably there are some that are not—might not be a bad idea to take a few moments to figure out what compliance (and any gaps) might look like if this goes to the end of April, or May, or even June. I’m hoping that you got all your quarterly stuff done early this quarter (don’t forget to check fire drills—some folks will wait until the end of the quarter—don’t want to miss anything), so it will be a question of keeping an eye on the longer-term future.

Stay safe and keep in touch as you can!

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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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