ASHE Education Shareable Articles for January 2022
Water Management in Health Care Facilities: Complying with ASHRAE Standard 188
This monograph gives guidance to health care facilities on how to comply with ASHRAE Standard 188: Legionellosis: Risk Management for Building Water Systems. Without proper guidance, hospitals may take steps that are not required; steps that may be unnecessarily costly; or steps that are not helpful in reducing the threat from legionellosis and other waterborne pathogens.
What is a Water Management Plan and Why is it Important?
Gary Milewsky, Corporate Manager Plant Engineering Compliance at Novant Health, discusses what a water management plan is, why it is important, and a few lessons learned from Novant Health’s almost decade of tweaking and refining their water management plan. Gary also provides some great insight into how their facilities and plant engineering team works with the environmental services team.
Developing a Water Management Plan of Action
“Some of the hardest things to prevent are the ones that we cannot see. The recent COVID-19 pandemic has forced health facilities to fight a virus that is not visible. There is a good chance that Legionella, an invisible bacterium, may exist within facility water systems and, if not monitored and controlled, may be transmitted to susceptible persons within the facility and possibly result in death.”…
ASHE Chapter Articles for September 2021
MEMBER OPPORTUNITY | Cast your vote in the ASHE 2021 elections
Help guide ASHE’s direction by casting your ballot for several key ASHE Advisory Board Member positions, including president-elect, associate member Advisory Board representative and Advisory Board regional representatives. This year’s president-elect candidates include Gordon Howie, regional director of facilities and construction services, Mayo Clinic Health System; Michael D. Roberts, director, corporate infrastructure, Atrium Health; and Skanda V. Skandaverl, division director, Catholic Health Initiatives. Go online to get to know the candidates and cast your vote soon. Voting closes Sept. 20.
ASHE
IN THE FIELD | Dealing with deferred maintenance
As hospital infrastructure continues to age and organizations continue to fight for funding, facilities managers must learn how and where to invest their budgets.
HFM
IN THE FIELD | Bringing reliability asset management to health care
Health care facilities managers are beginning to embrace this tried-and-true methodology used by many other high-risk fields.
HFM
ISHE Winter 2019 Newsletter
Welcome to the ISHE Member Newsletter, Fall Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Winter Newsletter!
ISHE Fall 2018 Newsletter
Welcome to the ISHE Member Newsletter, Fall Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Fall Newsletter!
ISHE Summer 2018 Newsletter
Welcome to the ISHE Member Newsletter, Summer Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Summer Newsletter!
ISHE's 2018 Fall Conference
"Moving Healthcare Construction Ahead in Idaho"
Call To Action!
Speaker Proposals Needed!
Submission for Presentations OPEN through: Friday, July 6th.
Click here for the Presentation Submission Form!
Email the Association office today with your proposal at ishe@aminc.org
Firestopping: Who, What, When, Where, Why & How
A Free Lunch & Learn.
Date: Thursday June 21st, 2018
Time: 12:00 pm -1:00 pm
Location: Idaho AGC Education Center
1649 W Shoreline Drive
Boise , ID 83702
Lunch is provided
AIA credit will be given to members.
Please RSVP by June 20th to Molly Sedlacek at sedlacekm@mti-id.com
Register Today!
ISHE Spring 2018 Newsletter
Welcome to the ISHE Member Newsletter, Spring Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Spring Newsletter!
ISHE Winter 2018 Newsletter
Welcome to the ISHE Member Newsletter, Winter Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Winter Newsletter!
New Idaho Underground Storage Tank Rules
The US Environmental Protection Agency (EPA) enacted changes to the 1988 federal underground storage tank (UST) regulations. An overview of the major provisions of the regulations adopted by Idaho, effective March 24, 2017, are provided below:
Tank fees.
Monthly walkthrough inspections.
Release detection requirements.
Annual testing requirements for release detection equipment.
3-year testing requirements for overfill devices (e.g., phase-out ball floats), spill buckets, and containment sumps.
UST system fuel compatibility.
Suspected release reporting.
UST system repair changes.
UST internal lining inspection update.
Change of ownership requires 30-day notice.
Click here to read more.
ISHE Fall 2017 Newsletter
Welcome to the ISHE Member Newsletter, Fall Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Fall Newsletter!
CMS issues training on emergency preparedness rule enforcement
The Centers for Medicare & Medicaid Services has released an online training course for state survey agencies that will evaluate compliance with new emergency-preparedness requirements for hospitals and other providers beginning Nov. 15. The course also is available to providers to give consistent guidance on the survey process.
A final rule issued last September requires health care facilities to conduct risk assessments using an all-hazards approach; develop emergency-preparedness plans, policies and procedures, including distinct communications plans; and establish training and testing programs. Hospitals, critical access hospitals and long-term care facilities also must have emergency and standby power systems that reflect their emergency plans.
Get up to speed on NFPA 99 requirements for medical gas and vacuum systems
ASHE members have free access to a September 19 webinar covering the newly adopted 2012 edition of NFPA 99: Health Care Facilities Code. The webinar will focus on how the risk assessment requirements of the new Chapter 4 affect the requirements for medical gas and vacuum systems in Chapter 5. The webinar will also highlight installer and verifier qualifications, and the maintenance and testing of system components. Continue reading
ASHE Scholarship Winner!
ISHE congratulates Mike Bourland! Mike was awarded the Ilse B. Almanza Scholarship Fund from ASHE.
The Ilse B. Almanza Scholarship Fund supports education and training to develop future leaders committed to optimizing the health care physical environment. The scholarship was established to carry forward the legacy of Ilse B. Almanza, an advocate for lifelong education and longtime ASHE employee.
Mike is a Senior Building Services mechanic at St. Luke’s Health System in Meridian, Idaho. Mike holds certification as a Building Operator from Northwest Energy Efficiency Council and is a current ISHE member. He is an advocate for patient comfort and safety and always looking for opportunities to improve the processes to the hospital environment. Mike has implemented the elevator maintenance program in the Treasure Valley and continues to improve workflows and efficiencies. Mike is currently enrolled in the Owensboro Healthcare Facility Leadership program earning his AAS degree.
Prior to his employment at St. Luke’s, Mike obtained his Mine Safety and Health Association instructor certification. Among many roles at a gold mine in eastern Oregon, Mike ensured the safety of the entire mining operation team.
Coaching lacrosse occupies much of Mike’s free time, along with mountain biking in the Boise foothills. He enjoys spending time with his wife of 21 years and their two children.
ISHE 2017 Summer Newsletter!
Dear ISHE Member,
Welcome to the ISHE Member Newsletter, Summer Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Spring newsletter!
2017-2018 Conference, Sponsor & Volunteer Information!
ASHE Insider
Click here for the latest edition of the ASHE Insider!
ISHE 2017 Spring Newsletter!
Dear ISHE Member,
Welcome to the ISHE Member Newsletter, Spring Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Spring newsletter!
ASHE and Healthcare Infrastructure Research program looking to highlight innovation
ASHE is working with the Healthcare Infrastructure Research program in Washington, D.C., to identify and highlight innovations in our field. ASHE members and others can submit innovative work from their hospitals or companies for consideration in this project. A team of top health care representatives from various organizations–including Cleveland Clinic, Kaiser Permanente, Catholic Health Initiatives, HCA, VA, Defense Health Agency, and National Institutes of Health–will be reviewing submissions. The team will highlight innovations that have advanced the effectiveness of American health care facilities and will outline actionable strategies for future innovation. Submit your innovative work today using a quick online form, which can also be used to indicate interest in underwriting or sponsoring this project.
Continue to this online form
ISHE 2017 Winter Newsletter!
Dear ISHE Member,
Welcome to the ISHE Member Newsletter, Winter Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Winter newsletter!
Give your input on a potential change to ASHRAE 170
ASHRAE recently published an addendum to ASHRAE 170: Ventilation of Health Care Facilities to clarify requirements for steam humidifiers and adiabatic atomizing humidifiers. A PDF of the published addendum can be downloaded here. Also, ASHRAE is seeking comments on another proposed addendum to ASHRAE 170. Proposed addendum o would allow health care providers that have the expertise to analyze, implement, and document their specific ventilation requirements to use a risk-based approach to establish alternate ventilation rates. The proposed change is out for First Advisory Public Review Draft until January 15. ASHE encourages members to review this proposal and submit advisory comments before the January 15 deadline.
2017 Sponsorship Opportunities Now Available!
If you would you like to take advantage of ISHE's 2017 sponsorship opportunities please click here!
Various sponsorship levels have been established for partners of all sizes. Please click here to evaluate which level of sponsorship is best for your organization.
Continue reading
What the Trump presidency will mean for health care
The American Hospital Association is inviting ASHE members to watch a recording of a Town Hall discussion on the election results and what they mean for health care facilities. The Town Hall addresses policy versus politics, the future of the Affordable Care Act, key players in the new administration, and big issues still at stake in Washington.
Continue reading
USP 800 brings new regulations to hospital pharmacies
New rules for handling hazardous drugs are more comprehensive and stringent
November 2, 2016
William N. Bernstein, LEED AP, AIA
A pharmacy cleanroom at Santa Barbara (Calif.) Cottage Hospital, designed by Bernstein & Associates, Architects.
The U.S. Pharmacopeial Convention (USP) has introduced an important new chapter on compounding standards in the 2016 compounding compendium called USP 800, Hazardous Drugs (HDs) — Handling in Healthcare Settings.
Many people in the health care environment are already familiar with USP 797, Pharmaceutical Compounding — Sterile Preparations. USP 800 is not as widely known, but that is about to change. First published in February, USP 800 will become officially enforceable on July 1, 2018.
As the title indicates, USP 800 addresses the handling of HDs in a hazardous setting. This topic had been addressed in a substantial manner in USP 797; however, in the creation of USP 800, USP has created a separate guideline to address just HDs (and is currently revising and reissuing USP 797 accordingly).
The USP 800 guidelines on handling HDs are now more comprehensive and stringent than they were in USP 797.
Click here to read more.....
CMS Call on Emergency Preparedness Rule!
The Emergency Preparedness Requirements Call on 10-5-2016 is now available online!
Description: The Emergency Preparedness Requirements final rule established national requirements for Medicare and Medicaid providers. During this call, CMS discusses the new requirements and revisions in the final rule, as well as how to plan for both natural and man-made disasters, while coordinating with other emergency preparedness systems. A question and answer session follows the presentation.
Agenda:
- Provisions of the final rule
- Enforcement process
- Overview of available technical assistance
Target Audience: The final rule applies to 17 categories of providers and suppliers:
- Hospitals
- Critical Access Hospitals
- Long-Term Care Facilities, Skilled Nursing Facilities, and Nursing Facilities
- Religious Nonmedical Health Care Institutions
- Ambulatory Surgical Centers
- Hospices
- Psychiatric Residential Treatment Facilities
- Programs of All-Inclusive Care for the Elderly
- Transplant Centers
- Intermediate Care Facilities for Individuals with Intellectual Disabilities
- Home Health Agencies
- Comprehensive Outpatient Rehabilitation Facilities
- Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services
- Community Mental Health Centers
- Organ Procurement Organizations
- Rural Health Clinics and Federally Qualified Health Centers
- End-Stage Renal Disease Facilities
Call Materials:
Slide Presentation [PDF, 925KB]
Written Transcript [PDF, 350KB]
Registration: To register for an MLN Connects Call, please visit the MLN Connects Event Registration website.
2018 FGI Drafts Available
Dear ISHE members, below is the press release announcing the 2018 revision cycle public comment period. Please share with others who may be interested!
Access Drafts and Comment Systems
Public Invited to Review and Comment on Draft 2018 FGI Guidelines Documents
The Facility Guidelines Institute (FGI) invites users of the FGI Guidelines to comment on its draft 2018 documents, posted for public review beginning September 29, 2016. Input from the field is critical to revising the Guidelines documents, which provide fundamental standards for design and construction of hospitals, outpatient facilities, and residential health, care, and support facilities.
The multidisciplinary, 100-member Health Guidelines Revision Committee (HGRC), the body responsible for the content of the Guidelines, revises and updates the text every four years to keep pace with changes in the health care and residential care fields and to clarify the requirements to make compliance easier. “Although we are only in the middle of revising the FGI Guidelines documents, HGRC members have been putting forth a yeoman’s effort to verify the need for existing requirements and validate newly proposed language,” said Douglas Erickson, FASHE, CHFM, CHC, HFDP, chair of the 2018 HGRC. “Now we need users of the Guidelines to review the draft documents and provide comments, supportive or constructive, for consideration by the HGRC during the final stages of developing the 2018 documents.”
The 2018 Guidelines revision cycle will yield three Guidelines documents—for hospitals, for outpatient facilities, and for residential health, care, and support facilities. Therefore, three drafts have been created as well as an electronic comment system for each book. To learn more about the comment period, to access the draft, and to link to the three comment systems, please visit the FGI website.
The public comment period will close on December 12, 2016. Comments may be made only on proposed changes to the text (deletions, revisions, or new material) in the 2014 FGI Guidelines for Design and Construction of Hospital and Outpatient Facilities and Guidelines for Design and Construction of Residential Health, Care, and Support Facilities. Following are some of the changes proposed for the 2018 FGI Guidelines documents:
Hospitals and Outpatient Facilities
- New guidance on design of telemedicine spaces
- New design requirements for accommodations for care of patients of size
- Clarification of procedure room and operating room requirements: procedure types, facility types, hybrid ORs
- New classification structure based on procedures performed and patient acuity for determining imaging room requirements
- New flexibility in pre- and post-procedure patient care area design requirements
- Two options for sterile processing area design: two required rooms (decontamination and clean) with an exception for a single room for small tabletop sterilizers
- New design requirements for a sexual assault forensic examination room
- Revised mobile/transportable medical unit chapter
- Updated acoustics requirements
- Expanded sustainability requirements re: waste minimization, potable water, and energy efficiency
- Revised guidance for emergency preparedness and management (formerly provisions for disasters)
Residential Health, Care, and Support Facilities
- Updated acoustics and lighting requirements
- Updated minimum requirements for grab bar configurations to align with the latest research
- New chapter on settings for individuals with intellectual and/or developmental disabilities
- New chapter on long-term residential substance abuse treatment facilities
- New telemedicine section to address the increasing provision of telemedicine services in residential facilities
- Language shift from “bariatric resident” to “person of size” since people who need accommodations include those who are not necessarily obese or receiving treatment for obesity, such as very tall people
Commenters are asked to provide their take on the costs and benefits of any changes to the draft text they submit, using an optional cost/benefit comment box and a required cost/benefit matrix provided in the comment systems. The FGI Cost/Benefit Committee will review all comments and make recommendations to the HGRC.
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ASHE is conducting a survey of health care facilities to collect operational characteristics and 2015 energy and water consumption data. The survey will quantify trends in energy and water use in health care facilities. Additionally, the data will be anonymously shared with EPA with the goals of:
- Updating the ENERGY STAR 1-100 score models for both General Medical & Surgical Hospitals and Medical Office Buildings
- Expanding to new ENERGY STAR 1-100 score models for other health care space types
- Evaluating the potential to develop a 1-100 score for water efficiency
All health care organizations are encouraged to participate. The deadline to complete your submission is October 14, 2016. A webinar and Q&A session will be held on September 14, 2016 at noon Central Time.
Click here to access the Survey! Click here to Register for the September 14th Webinar!
The success of ASHE's effort will largely depend on the response rate, so please set aside time to complete this important survey. To help encourage participation, ASHE will randomly select one survey participant from each ASHE region to win a $250 Amazon gift card.
If you currently use Portfolio Manager, you will be able to share your Portfolio Manager data with ASHE, which allows you to skip sections of the survey. You will still need to provide additional operational characteristics about your facility.
Questions? Please contact ASHEenergy@aha.org.
CMS issues correction to new fire safety requirements
The Centers for Medicare & Medicaid Services in June published a correction to its recently updated fire safety standards for hospitals. The May final rule adopted the National Fire Protection Association’s 2012 Life Safety Code (with minor amendments) and most chapters of its 2012 Health Care Facilities Code for hospitals and certain other facilities that participate in the Medicare and Medicaid programs. The correction states that hospital outpatient surgical departments must meet Life Safety Code provisions applicable to ambulatory health care occupancies, “regardless of the number of patients served.” The standards for ambulatory health care occupancies normally apply to facilities that provide services simultaneously to four or more patients.
Joint Commission stops considering Plans for Improvement
The Centers for Medicare & Medicaid Services (CMS) has asked the Joint Commission to make several changes to its Statement of Conditions process and the Joint Commission will no longer consider hospital Plans for Improvement (PFIs) starting Aug. 1, the American Society for Healthcare Engineering (ASHE) told its members in an Advocacy Alert email blast this month. The major changes, which were announced at ASHE’s annual meeting in Denver by George Mills, FASHE, CEM, CHFM, CHSP, director of engineering with the Joint Commission's Department of Engineering, call for all life safety deficiencies to be corrected within 60 days, although a time-limited waiver process will be available through CMS regional offices. Mills said the PFI process still can be used as an internal management process.
ASHE video explains CMS changes to health care field
Changes to the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation requirements have brought up many questions from health care facility managers. Tim Adams, FASHE, CHFM, CHC, American Society for Healthcare Engineering’s (ASHE) director of member professional development, answers many questions in a new video addressing the CMS changes.
The 42-minute video can be accessed by non-ASHE members, and the organization encourages viewers to share the resource with health care executives within their facilities. CMS will begin surveying hospitals according to the new requirements in November.
Mark P. Grimes has Retired
After 10 years as AHJ, today is my last day as the Idaho Facility Fire Safety and Construction Supervisor. I wish you all success and satisfaction in your careers and personal lives. My career has been extremely satisfying and I have been honored to have worked with you, but now it is time to focus on family and friends in this new chapter. Nathan Elkins will be the new Health Care Licensing AHJ in Idaho, he will do a fine job in helping you to build and maintain a safe environment in Idaho facilities.
As always, feel free to contact me if you need something, I am retiring, but will always want to help if I can.
Sincerely,
Mark P. Grimes
Fireguy43@hotmail.com
ISHE 2016 Summer Newsletter!
Dear ISHE Member,
Welcome to the ISHE Member Newsletter, Summer Edition. If you are not currently an ISHE member, we hope that you will join our award winning organization. Please feel free to share this newsletter with interested parties. Click here for the Summer newsletter!
ISHE has earned the Platinum Level of Affiliation with ASHE for 2015!
The Platinum Level is the highest Level of Affiliation that can be attained by an ASHE Chapter. This accomplishment reflects our membership's dedication to Education, Leadership, Communication, and Advocacy for the Healthcare Engineering profession.
ASHE chapters participating in the Levels of Affiliation Awards Program submit documentation demonstrating that they have met several criteria based on affiliation objectives ASHE would like to achieve to make its chapters stronger and more viable, which in turn benefits the fields of healthcare engineering and facilities management.
Way to go ISHE!
Joint Commission deletes some program requirements
The Joint Commission recently approved deletion of 131 requirements from its hospital accreditation program that it states are no longer necessary because they have become a routine part of operations and clinical practice. For instance, Element of Performance Standard EC.02.03.01 states that hospitals must take measures to minimize fire risk if patients are permitted to smoke. The Joint Commission states that it is being deleted because it is duplicative of another Element of Performance Standard. The changes will go into effect July 1.
Adoption of the 2012 edition of the Life Safety Code
After several long years the wait is now over! Starting July 5th, CMS will be using the 2012 edition of the code. The best news is that with you and your chapters support, CMS heard our concerns with their proposed rule. I would say that the final rule looks pretty good considering where it started. The changes that CMS made wouldn’t have happened without the comments submitted by your members.
Some notes of the new rule include:
- Hospital providers can use the appropriate occupancy types for the situation per the Life Safety Code
- CMS didn’t go with the 4 hour fire suppression out of service rule
- The window sill requirements will only apply to NEW construction
- Smoke evacuation will not be required in operating rooms
- Roller latches will be permitted in some situations
Additionally, the adoption of the 2012 edition virtually eliminates the need for all of the categorical waivers and I believe we can now use maintenance free batteries on our Gensets (perhaps a small issue but that one sure feels good to have behind us)
In preparation for the adoption we have provided, and will continue to develop several resources. Please take a few moments to review the content provided on our Life Safety Code adoption website. We have several articles that will detail each of the requirements, the final CMS rule, a webinar series, on demand webinar recordings and previous conference sessions that will help you comply with the new regulations. Bookmark this page as it will be continuously update over the next several months.
I know everyone has a lot of questions, so we are collecting questions about the adoption and I encourage you to share this link with your members: SUBMIT A QUESTION ABOUT THE NEW REGULATIONS We will be answering the questions we can and creating a Frequently Asked Questions section on the website.