Monday, July 30, 2012

Strategic management of health care organization: Exhibits of a health care organization (ficticious)

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THE IROC MEDICAL CENTER

00-00 STANDARDS FOR AMBULATORY

MANAGEMENT OF THE ENVIRONMENT OF CARE

The IROC Medical Center provides an effective environment of care as described by the 00-00 ambulatory standards. The goal of this Medical Center is to provide a safe, functional, supportive, and effective environment for patients, staff members, and other individuals in the organization. The standards in the IROC Medical Center focus on how everyone in the organization participates in the processes and activities that make the care environment safe and effective. The standards also address department leaders’ responsibility for identifying and communicating the care environment needs to the organization and allocating appropriate space, equipment and resources to safely and effectively support the organization’s services.

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STANDARDS AND GUIDELINES

PLANNING EC. 1

The organization plans for a safe, accessible, effective, and efficient environment consistent with its mission, services, laws, and regulation.



EC. 1.4 The organization has an emergency management plan. [See exhibit 1]

IMPLEMENTATION EC.

The organization provides a safe, accessible, effective, and efficient environment consistent with its mission, services, law, and regulation.

EC. .1 The organization implements its safety plan [See exhibit ].

EC. .10. Medical equipment is maintained, tested, and inspected. [See exhibit 4]

OTHER ENVIRONMENTAL CONCERNS EC.

The organization plans and provides for other environmental concerns.

EC. .1. The organization provides an environment with appropriate space and equipment. [See exhibit 5]

MEASURING OUTCOMES OF IMPLEMENTATION EC. 4

The organization evaluates and improves conditions in the environment.

EC. 4.1 The organization collects information about deficiencies and opportunities for improvement in the environment. [See exhibit ]



EXHIBIT 1

IROC MEDICAL CENTER

THE ORGANIZATION HAS AN EMERGENCY MANAGEMENT PLAN

THE EMERGENCY PREPAREDNESS PLAN EC.1.4

IROC Medical Center shall maintain a comprehensive Emergency Plan. Emergency management guidelines shall be developed and made widely available to all medical center staff. The plan will address the major components of required for a successful emergency plan. The plan will include the essential components of risk mitigation, emergency preparedness, emergency response, recovery and also education.

DESCRIPTION

The Emergency Preparedness Plan sets procedural guidelines for all personnel in the event of a mass casualty or facility disaster situation at IROC. This plan has been developed in conjunction with key departments and coordinates with other state and community agencies.

The plan is based on several principles fundamental to Emergency Planning

• Risk Mitigation- means all efforts have been made to reduce the consequences should a disaster of any type occur.

• Emergency Preparedness- addresses that all the components are in place so that personnel and systems can react properly and positively to all potential sources of a disaster and that a control structure is in place to manage the emergency.

• Emergency Response- addresses that a properly managed response plan has been developed and is understood by all staff responsible for responding to a facility mobilization. The response systems are activated and utilized correctly to safely manage a disaster and to reduce confusion and stress to staff and services.

• Recovery- describes a system in place to ensure all system can return to normal operation. A significant component of recovery is financial. Systems are in place to document all consequences, financial, and physical.

PRIMARY GOALS

A. Preparedness to respond to variety of disasters and emergency situations including but

not limited to

• Assaultive Behavior

• Bio-terrorism or weapons of mass destruction attack

• Bomb threat

• Civil Disturbance

• Evacuation

• Fire

• Hazardous materials spill

• Security situations

• Utility Failure

This and other departmental manuals contain plans and processes for responding to above and other

emergency situations.

B. Coordinate prompt transfer of casualties to the most appropriate facility for administering effective care after preliminary medical or surgical services have been provided and initiate procedure for prompt discharge or transfer of patients from IROC to Community General who can be moved without jeopardizing their health or recovery.

C. Provide Security Services to manage personnel access to emergency response areas and provide information to the public on the emergency, patient status, and related matters.

D. Convert usable space in defined areas for efficient patient care services and maintain availability of adequate basic utilities and supplies including water, gases, food, and essential medical and supportive materials.

E. Protect and maintain physical plant facilities and provide social services, including religious and psychological support, to staff, patients, and visitors.

Reasons to activate the Emergency Plan are as follows

• Mass casualty incident

• Loss of utilities or facilities due to damage or equipment failure

• Structural damage to medical center buildings that affect patient care activities

• Major hazardous material spills

• Civil disturbance

• Any other event that could negatively impact hospital functions.

EMERGENCY PREPARDNESS PLAN SEQUENCE

1. The Administrator-on-Call (AOC), Senior Administrator or Nursing Supervisor can activate the Facilities Mobilization Plan once they have recognize that a emergency situation is occurring or is imminent.

. To activate the plan, one of the above authorities will call the hospital operator (78-084) and instruct the operator to announce that the Facilities Mobilization is now in effect. The operators will then initiate the proper overhead notification, pager notification and telephone calls as stated in the established procedures.

. Departments are to implement their department-specific procedures when the announcement or other communication is made.

4. During the emergency, the Medical Center departments are to continue standard operating procedures as much as possible. Non-essential staff should report to the Personnel Pool.

5. Plan deactivation should include agreement between the Incident Commander, Emergency Department, and/or Security Services or facilities ensuring the emergency is under control, and special operating procedures are no longer needed. A limited response may still be required to return operating conditions.

6. Each Department will have a department specific plan outlining key emergency response plans for their immediate area and their role, if any, in a facilities mobilization.

AUTHORITY AND RESPONSIBILITIES

The Emergency Preparedness Subcommittee has overall responsibility for management of the Emergency Preparedness Plan, and is under the direction of the IROC Medical Center Environment of Care Committee (ECC) in congruence with the 00-00 Standards for Ambulatory Care. All policies and procedures are approved according to the guidelines. The emergency preparedness subcommittee reports quarterly to the Environment of Care Committee. Managers are responsible for developing department-specific emergency plans.

ANNUAL EFFECTIVENSS EVALUATION

The Emergency Preparedness Plan will be evaluated annually on objectives, scope, performance and effectiveness by the Emergency Preparedness Subcommittee.

POLICY REVIEW AND UPDATES

This policy supercedes any policies before it. It shall be reviewed at least every three

years and whenever it is requested by the ECC.

APPROVAL

_____________________________________________________________

Safety Officer Date

_____________________________________________________________

Associate Director Date

_____________________________________________________________

Executive Director Date

REVIEWED

_____________________________________________________________

Signature Date

_____________________________________________________________

Signature Date



EXHIBIT

IROC MEDICAL CENTER

THE ORGANIZATION IMPLEMENTS A SAFTEY PLAN EC. .1

IMPLEMENTATION

The organization provides a safe, accessible, effective, and efficient environment consistent with its mission, services, law, and regulation.

POLICY

The IROC Medical Center shall take actions to maintain a safe and healthy environment through the implementation of an Environment of Care Program. The Environment of Care shall assess the potential risks of injury to patients, staff, and visitors and the risk of loss or damage to facilities or equipment assets and shall implement programs to minimize such risks. The Environment of Care Program shall comply with local, state, and federal laws and meet the requirements of the relevant accrediting agencies.

PROGRAM DESCRIPTION

The Safety Program incorporates the activities of the seven Environment of Care Programs Safety, Hazardous Material, Fire/Life Safety, Emergency Preparedness, Medical Equipment and Buildings and utilities as well as activities of infection control, Risk Management, Employee Health Services and other health and safety programs. The Safety Officer has overall responsibility for implementation of the Environment of Care Program and the Environment of Care Committee establishes the appropriate subcommittees representing functional areas. The Safety Program complies with the 00-00 JCAHO standards.

PROGRAM IMPLEMENTATION

A. Environment of Care Committee (ECC)



The ECC is responsible for the creation, implementation, monitoring, evaluation, and

improvement of the Safety Program. The committee is composed of representatives

from administrative, clinical and support services and meets at least ten times per

year.

Subcommittees that represent the ECC monitor safety activities, solve problems, set

Performance standards recommend policy and program changes and are the driving

Force behind the safety programs. Task forces are established to address specific,

targeted issues.

The ECC continuously identifies hazards and risks through the implementation of

Data Gathering and Analysis System (DGAS). The DGAS is discussed in further

detail in exhibit . The DGAS gathers the following types of data

1. Performance data- sources of performance data include but are not limited to

a. Facility Rounds

b. Staff interviews

c. Fire drills

d. Safety minutes

e. Security Rounds

. Critical incidents- Sources of critical incidents include but are not limited to

a. Assaults of staff

b. Air quality complaints

c. Employee Injuries and Illness

d. Fires

e. Failure to follow emergency procedures

f. Hazardous Material Spills

g. Theft

Once hazards have been identified and information collected the ECC will determine the appropriate actions to be taken depending on the risk assessment. The implementation outcome measurements for this standard are discussed in detail in Exhibit



EXHIBIT

IROC MEDICAL CENTER

THE ORGANIZATION COLLECTS INFORMATION ABOUT DEFIECIENCES AND OPPORTUNIES FOR IMPROVEMENT IN THE ENVIRONMENT EC. 4.1

MEASURING OUTCOMES OF IMPLEMENTATION

POLICY

Each Department of the IROC Medical Center shall have an Environmental of Care Plan which addresses specific issues related to safety, security, hazardous materials, emergency preparedness, fire/life safety, medical equipment and utilities. Staff shall be trained about the hazards and risks specific to working in their departments and shall be trained to appropriately collect information about deficiencies, minimize risks, and handle emergency situations for the improvement of the environment.

PROGRAM DESCRIPTION

The Environment of Care Committee serves as a resource to all departments to assist with the developing of their plan. The ECC continuously identifies hazards and risks through the implementation of the Data Gathering and Analysis System (DGAS). The DGAS gathers the following types of data, which include but is not limited to

1. Performance data- sources of performance data include but are not limited to

a. Facility Rounds

b. Staff interviews

c. Fire drills

d. Safety minutes

e. Security Rounds

. Critical incidents- Sources of critical incidents include but are not limited to

a. Assaults of staff

b. Air quality complaints

c. Employee Injuries and Illness

d. Fires

e. Failure to follow emergency procedures

f. Hazardous Material Spills

g. Theft

To assist departments developing their plan, a series of question has been outlined in this section and are intended to guide departments through the major considerations that should be made for each functional area.

The questions and checklist in this section must be completed and signed/dated by the Department Manager.

The ECC will then review the department plan and make recommendations, if deemed necessary.

IROC MEDICAL CENTER DEPARTMENTAL CHECKLIST

________________________________________________________________________

A. SAFTEY MANAGEMENT (check off all potential hazards in your area)

__Tripping hazards

__Sharp objects

__Potential exposures to bodily fluids

__Burns for hot materials

__Back injuries from lifting

__Hazardous chemicals utilized in the area

__Other





Check safety precautions your department has implemented to reduce or eliminate the identified hazards



__Staff training and tours with new staff showing tripping or falling hazards in

area

__Staff has been trained on all available safety devices and have been instructed

on how to use them safely.

__Staff has been shown how to handle hazardous spills and been provided with

personal protection equipment.

__Staff has been instructed on how to avoid back injuries

Staff knows the following safety information for the department



__Location of the ECC manual

__Numbers to call for safety needs

__Safety Coordinator for the Department



A. FIRE/LINE SAFETY MANAGEMENT- All staff working in this department must

know the following.

__ The location of sprinkler heads

__ The location of the nearest fire alarm pull boxes

__ The location and use of fire extinguishers

__ The evacuation maps

B. EMERGENCY MANAGEMENT RESPONSE

__ An understanding of facility mobilization

__ Location of nearest emergency supplies

C. MEDICAL EQUIPMENT MANAGEMENT

__ Location of red outlets and equipment that is connected to emergency power

__ Number to call for broken equipment

__ Safety check label on all medical equipment

__ Departmental policy and procedure for using new medical equipment

D. HAZARDOUS MATERIALS, WASTE HANDLING AND DEPARTMENT

HAZARDS

__ Number to call for Hazardous spill

__ Location of Department spill kit

__ List of hazardous chemicals used in the department

__ Procedure for spill cleanup

__ Other

F. SECURITY

__ Personal items are secured in a locked area

__ Department equipment has been secured with a lock system

__ All visitors must check in at receptionist desk and present valid ID

__ Other

G. EDUCATION AND TRAINING

__ Staff meetings (documentation and attendance lists available)

__ Documented staff-in service has been conducted

__ The Department receives employee injury reports to track and correct hazards.

__ Manager observes that employees use proper lifting technique when lifting

patients

__ Use of personal protective equipment.



REMINDER Please send a copy of this checklist to John Doe at the IROC Medical Center Safety Office Health City USA.



EXHIBIT 4

IROC MEDICAL CENTER

MEDICAL EQUIPMENT IS MAINTAINED, TESTED, AND INSPECTED

EC. .10.

POLICY

The purpose of the IROC Medical Equipment Plan is to provide safe, clinically appropriate and cost-effective medical equipment for patient care and to assure that users of medical equipment are properly trained. It is the intent of this program to comply with any applicable state, federal and local laws and the requirements of accrediting agencies.

PROGRAM DESCRIPTION

The Medical Equipment Plan is a core component of the IROC Medical Center’s Environment of Care Plan. The Medical Equipment Plan is required by the 00 JAHO Standards and the Health City Administrative Code.

The Department Manager performs management of the medical equipment inventory database, establishes criteria for inclusion/exclusion of equipment in the inventory. Management provides for evaluation and testing of medical equipment prior to initial use. Management also oversees safety and preventive maintenance of equipment included in the Medical Equipment Plan. The plan assists managers and Supervisors help in the development and provision of medical equipment continued education. The plan assists in developing an implementing effective planning of emergency procedures for medical equipment failures.

INSPECTION, TESTING AND MAINTENANCE OF MEDICAL EQUIPMENT

A. The purpose of the inspection, testing and preventive maintenance program is to minimize the clinical and physical risk associated with medical equipment.

1. Initial inspection- a safety inspection shall be performed on every piece

of equipment received by the medical equipment department.

a. The equipment will be tested to confirm operation and compliance with

the appropriate standards.

b. If the equipment fails, it will be returned to the manufacturer.

. Scheduled Preventive Maintenance

a. Once a month, this Department will generate a report for all equipment due

for inspection.

b. Clinical Engineering will perform the inspections (pass/no pass) according to

manufacture’s recommendations.

c. The prior inspection sticker will be removed and replaced with a

new one.

d. An equipment history record will be initiated for the preventive maintenance

performed.

f. All staff or employee owned medical equipment must be checked by Clinical

Engineering prior to use. Clinical Engineering shall place a safety sticker to

indicate that it passed the criteria for use of Clinical use.



B. EDUCATION AND TRAINING

a. Emergency procedures addressing equipment failure are taught by in-house

vendor supplied training. Education is provided, as needed, to optimize staff

competencies.

b. Technicians are given necessary information to perform maintenance

responsibilities through manufacturers service manuals and training

information.

c. The Educational and Training Subcommittee of the ECC is responsible for

assuring that the content of new employee orientation and annual safety training is

appropriate and that it includes education about medical equipment.

C. PERFORMANCE IMPROVEMENT

a. The ECC is committed to continuous performance improvement as a central

goal. Annual performance standards are established for each Program which

actual performance is measured.

ANNUAL EFFECTIVENESS EVALUATION

The Medical Equipment Program will be evaluated annually on goals, scope, and

effectiveness by the Medical Equipment Subcommittee and will be reported to the

ECC.



APPROVALS

Original Tina Marie, Technician, September 00

Donna Grant, Medical Center Facilities September 00

Reviewed Missy Williams, Associate Director October 00

Approved Medical Equipment Subcommittee November 00

EXHIBIT 5

IROC MEDICAL CENTER

THE ORGANIZATION PLANS AND PROVIDES FOR OTHER ENVIRONMENTAL CONCERNS.



THE ORGANIZATION PROVIDES AN ENVIRONMENT WITH APPROPRIATE SPACE AND EQUIPMENT. EC..1.

POLICY

The IROC Medical Center will provide a safe, functional, supportive, and effective environment for patients, staff members, and other individuals in the Medical Center. This is crucial to providing quality patient care, achieving good outcomes, and improving patient safety. It is the intent of this program to comply with any applicable state, federal and local laws and the requirements of accrediting agencies.

MISSION

The IROC Medical Center goal is to improve the quality of patient care and patient safety. Performing strategic and on-going master planning by hospital leaders for the space, clear circulation of occupants, equipment, support environment, and resources needed to safely and effectively support the services provided. Planning and designing of the environment is consistent with the hospital’s mission and vision, and the patient’s physical condition/health, cultural background, age and cognitive abilities.

PROGRAM DESCRIPTION

The program creates a safe, welcoming, and comfortable environment that support and maintain patient dignity and personhood, allow ease of interaction, reduce stressors, and encourage family participation in the delivery of care. Effective management if the environment of care includes using processes and activities to do the following

• Reduce and control environmental hazards and risks

• Prevent accidents and injuries

• Maintain a clean, functional, well lit environment

• Space size and configuration that are appropriate and consistent with the clinical philosophy

• Maintain an environment that is sensitive to patient needs for comfort, social interaction and positive distraction.

• Orientation and access to nature and the outside

• Clarity of access (both exterior and interior circulation)

RATIONALE

The Environment of Care Committee (ECC) measures staff and hospital performance in managing and improving the environment of care. It is important that the physical environment is functional and promotes healing and caring. Certain key physical elements in the environment can be significant in their ability to positively influence patient outcomes and satisfaction and improve patient safety. These elements can also contribute in creating the way the space feels and works for patients, families, visitors, and staff experiencing the care, treatment, or service delivery system.

IMPLEMENTATION

1. ECC ensures that interior spaces are appropriate to the care, treatment, and services provided and the needs of the patients related to age and other characteristics.

. Include closet and drawer space provided for storing personal property and other items provided for use by patients. Lockers, drawers, or closet space is provided for patients who are in charge of their own personal grooming and who wear street clothes.

. furnishing and equipment are properly maintained and in good repair

4. Patient living, dining, and recreation areas are safe, clean, functional, and comfortable.

5. Lighting is suitable for care, treatment, or services and specific activities being conducted.

6. Door locks and other structural restraints used are consistent with the needs of patients, program policy, law, and regulation. Emergency access provision is provided to all locked occupied spaces. Each medicine preparation room door shall be equipped with a device which causes an unattended door to close, latch and lock without manual assistance.

RESPONSIBILITY

It is the responsibility of the ECC subcommittee to ensure that a review is performed, a resolution log is generated, and that follow-up actions are taken to correct deficiencies.

EFFECTIVENESS EVALUATION

The Patient Environment Improvement Program (PEIP) will be evaluated semiannually on objectives, scope, performance and effectiveness by the ECC Subcommittee of the ECC.

APPROVALS

Original Larry Johnson, Security September 00

Donna Grant, Medical Center Facilities September 00

Reviewed John Cromwell, Director of Nursing October 00

Approved Environment of Care Committee November 00



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