Hospitals

The Joint Commission’s IAQ Requirements

For over a decade now The Joint Commission has taken an increasing interest in indoor air quality (IAQ) issues. In the early 1990’s The Joint Commission recommended that hospitals develop an IAQ plan as part of the facilities “Safe Environment of Care Inspection Process”. In 1997 a handbook on IAQ termed “A Guide to Managing IAQ in Health Care Organizations” was published by The Joint Commission. This handbook included sections on:

• Risk factors for occupational exposures
• Recognizing these risks and implementing an IAQ program
• Economic considerations and the benefits of IAQ programs
• Appendices included: IAQ sampling checklists, inspection logs and complaint forms.

Beginning in 1999, The Joint Commission announced that they were modifying their Utility Management Standard to include checking, testing, and management of IAQ issues. Then in 2004, requirements were added to address the importance of monitoring IAQ during construction and renovation projects. Over the years, these requirements further evolved and expanded into several standards as follows:

• EC.02.05.01 (EP5&6): Management of Utility Risks.  Requires each facility to "reduce the potential for hospital acquired illness to be transmitted through the utility systems"; minimize pathogenic biological agents in cooling towers, domestic hot and cold water systems, and other aerosolizing water systems and conduct risk assessments; manage airborne contaminants through maintenance and testing of ventilation rates, filtration, pressure relationships, verify ASHRAE codes and AIA guidelines are met, maintain documentation on these items.
• EC.02.06.01 (EP13): Requires facilities to maintain ventilation, temperature and humidity levels suitable for the care, treatment and services provided.
• EC.02.06.05 (EP2&3): IAQ Management During Construction.  Requires facilities to conduct preconstruction risk assessments (ICRA or PICRA) identifying risks associated with air quality, infection control, noise vibration and other hazards that affect care, treatment, and services; and requires action based on this assessment.

These Joint Commission requirements have been the standard operating procedure of Healthy Buildings International Inc in commercial, industrial and health care facilities since our incorporation in 1980. Furthermore, the regular comprehensive inspection reports not only support The Joint Commission accreditation by way of documentation, but also, prove due diligence and build a valuable resource should the facility ever be the subject of speculative plaintiff litigation. In practice, regular Proactive Monitoring (biannual, nine-monthly, or annual) appears to strike the optimum balance between cost and usefulness and with such comprehensive testing.

Healthcare facilities employing programs such as HBI’s Proactive IAQ Inspection and Monitoring Program and HBI’s IAQ Monitoring During Construction will meet The Joint Commission, local, state and all currently known national standards.

In the case of private hospitals, Veteran’s Affairs Medical Centers, outpatient health care facilities and nursing homes, all the new found attention to the indoor environment, and its impact on the organization, has elevated the status of the facility manager. But along with that elevated status has come increased responsibility to ensure that the indoor environment is indeed a healthy one. In the case of the health care administrator, that responsibility has become magnified. In a setting whose primary reason for existence is the restoration and maintenance of human health, any outside force working to erode that principle tenet cannot be tolerated.

Attainment of good Indoor Air Quality (IAQ) gives the health care administrator an almost moral imperative to act proactively.

Proactive Indoor Air Quality Inspection and Monitoring Program

 

HBI was the pioneer in designing and implementing proactive IAQ programs. Starting in 1980, HBI’s diverse professional staff has been applying extensive experience to address any IAQ related concern or problem an engineer, safety manager, or facility manager might face. Today, HBI remains the preeminent firm with experience embracing 4,000 buildings in no less than 45 countries. This unparalleled experience lends confidence that HBI’s findings are accurate, the recommendations are realistic, and the report and certificate of inspection received carry the weight of prominent credibility.