Due to the unique nature of healthcare facilities, construction projects require careful, specialized attention. As described in previous articles, a detailed risk mitigation plan should be undertaken before any project involving a healthcare related building begins. Through our legal experience in the construction area and participation in the ASHE Healthcare Certification process, we are able to identify a number of areas that should be evaluated for risk. These areas include the following:
- Air quality
- Shutdown and destruction of utilities
- Facility egress and ingress
- Access to patient care areas
- Hazards to patients, visitors, and staff
In evaluating these critical areas of risk, a number of risk reduction methods need to be developed and implemented. Possible methods include:
- Building barriers
- Controlling airflow
- Minimizing noise and vibration
- Scheduling time for activities that require special attention
- Accommodating the movement of patients, visitors, and staff
Failure to plan for these eventualities may well result in a “critical condition” for any construction project.
In addition, there are a number of authorities that may have jurisdiction over your project. Satisfying all standards requires a proactive assessment and prevention of risks to patients during construction, renovation, and maintenance. At minimum, all construction projects require special attention to debris removal, access to the site by construction personnel, and the closing of potential patient care units in an appropriate vicinity to the construction area, particularly in cases of area disturbance and dust production. The goal is to proactively implement methods to minimize risk. Waiting to devise a solution until the risk is encountered is often too late.
In evaluating a risk, it is essential to assess the potential loss or harm that may result from the risk and its probability of occurrence. Risks with a high level of loss impact and high probability of occurrence are obviously disasters waiting to happen and must be worked through in advance. Less severe or less likely risks must also be addressed in an appropriate manner. A risk assessment involves a determination of each risk value and threat.
In order to properly perform a risk assessment, an open and thoughtful process should be followed involving all those who are either impacted by the risk, create the risk, or have the opportunity to mitigate the risk. Identified risks can include a natural event (i.e. a flood), a technology-oriented event (i.e. loss of power), or human events (i.e. infections due to construction activity). Some of the key areas of risk include secured areas such as nurseries, psychiatric facilities, sally-ports, sterile areas, surgical and laboratory areas, and patient rooms. The appropriate Preconstruction Risk Assessment takes into account all the various key areas that need concentrated attention as well as the types of risk presented by the project. Prior to the project commencing, these risks will have been thought through and arrangements made to mitigate their occurrence and possible severity. For further information or any questions regarding this important topic please feel free to contact us.
Ronald H. Pollock, Esq.
ASHE Certified for Healthcare Construction Safety