Alerts, Briefs & Articles
This page contains archived information (see note to left).
This page is no longer updated. For the latest news and information regarding advocacy efforts, visit the ASHE news page. To access the Advocacy Report, visit our Resources page. Information on this page is archived information.
PDC Summit Highlights Teamwork in the Health Care Built Environment (March
A new article from ASHE outlines some of the overarching themes discussed during the 2012 International Summit on Health Facility Planning, Design and Construction™ (PDC Summit) earlier this month-including how teamwork is critical to creating the health care built environment. PDC Summit speakers said that teamwork affects everything from health care codes and standards to disaster response during emergencies. More...
CMS Considers Reducing Low-End Humidity Requirement, Outlines Interim Waiver Process (January 18, 2012)
The Centers for Medicare & Medicaid Services (CMS) is considering changing the low-end humidity requirement in operating rooms from 35 percent to 20 percent, according to the American Society for Healthcare Engineering (ASHE) of the American Hospital Association. ASHE has received word from CMS headquarters that the agency is looking to change its policy and that a draft memo on the subject is currently undergoing an internal review at CMS. More ...
Issue Brief: CMS Guidance on Maintenance Schedules (January 5, 2012)
The Centers for Medicare & Medicaid Services (CMS) recently issued a memo clarifying that in certain situations hospitals can perform preventive maintenance on non-critical equipment less often than recommended by the manufacturer. This memo to state surveyors shines a light on preventive maintenance schedules for hospital equipment. More ...
ASHE to Keep Members Informed about Contributing Factors in India Fire (December 12, 2011)
A new article that was e-mailed to ASHE members Monday states that ASHE leaders were shocked and saddened to learn about a fire Friday in a private hospital in eastern India that killed more than 90 people. As authorities investigate the fire and its causes, ASHE will monitor their reports and provide our members with analysis of factors contributing to the blaze. The article is on ASHE’s website.
Repaving the Advocacy Highway: ASHE and Chapter Liaisons Renew Communication Effort (December 12, 2011)
The American Society for Healthcare Engineering (ASHE) of the American Hospital Association has kicked off a renewed effort to increase advocacy communications between ASHE and its chapters and to get more people involved in advocacy work. A recent meeting between ASHE advocacy leaders and advocacy liaisons from Gold- and Platinum-level ASHE chapters marked the beginning of this endeavor, which ASHE hopes will support its goal of achieving science-based health care codes that provide an optimal level of patient safety without burdening hospitals with unnecessary expenses. A new ASHE article explains this effort to “repave the Advocacy Highway.”
Bronx Hospital Fire Shows Why Emergency Training Is Critical (December 4, 2011)
Health care leaders find few things scarier than thick smoke billowing out of a busy hospital as fire engines rush to the scene. But thanks to quick-responding staff members, thorough emergency plans, and equipment that functioned properly, leaders at the Montefiore Medical Center in the Bronx in New York City say a recent fire there looked much worse than it was. This incident, which caused no injuries or deaths, can serve as a reminder to facilities across the country of the importance of drills and provide lessons learned as hospitals evaluate their emergency plans. Read more about the fire and the hospital's response in this new ASHE article.
How to Submit Meaningful Comments to CMS Regarding Life Safety Code (November 29, 2011)
The Centers for Medicaid and Medicare Services (CMS) is now accepting comments on its proposal to adopt an updated edition of the National Fire Protection Association's NFPA 101: Life Safety Code®. ASHE supports the adoption of the 2012 edition and urges health care facilities to submit meaningful comments to CMS regarding this important change. ASHE Executive Director Dale Woodin, CHFM, FASHE, points out that comments should generate meaningful discussion on specific reasons why the 2012 edition is better than the 2000 edition currently required by CMS. Woodin urges facilities to submit detailed, individual comments related to actual experiences with the Life Safety Code. For example, hospitals should submit comments outlining challenges faced when complying with the 2000 edition—such as unwarranted citations or exorbitant costs—that would be avoided under the 2012 edition. Submitting generic comments simply urging CMS to adopt the 2012 edition without providing useful, substantive information will not help CMS consider the change. ASHE Director of Codes and Standards Chad Beebe, AIA, SASHE, said that offering details on unique, first-hand experiences is a much better way to make the case for adopting the 2012 edition than submitting "me too" comments that merely echo the positions of others. The deadline for submitting comments to CMS is December 23, and more information is available online at http://www.regulations.gov/#!documentDetail;D=CMS-2011-0160-0001.
Changes in ASHE Advocacy Staffing (November 14, 2011)
ASHE’s advocacy team has seen significant change recently with the promotion of Chad Beebe to director of codes and standards and the departure of ASHE Deputy Executive Director Douglas Erickson. ASHE congratulates Beebe on this promotion and wishes success for Erickson, who leaves an impressive list of advocacy accomplishments at ASHE for a position with Northstar Management Company in St. Louis, Mo. Beebe will now direct and manage ASHE’s advocacy work—building relationships with state and federal agencies, providing expert testimony, providing member support on codes, and impacting the efforts of consensus code development organizations. To learn more about the changes and what Beebe and Erickson have said about them, read this article.
ASHE Position on CMS Proposed Rule (October 21, 2011)
The Centers for Medicare & Medicaid Services (CMS) released a proposed rule October 18, 2011, that could affect many ASHE members and save hospitals across the country billions of dollars. The rule would revise the Medicare Conditions of Participation, which hospitals must follow to qualify for reimbursement from the Medicare and Medicaid programs. The rule seeks comments on whether CMS should adopt the 2012 edition of NFPA 101: Life Safety Code®, an edition that is closer than previous editions to the International Codes often used in health care construction. If the 2012 edition of the Life Safety Code is adopted, hospitals would face fewer costly instances of conflicting codes. ASHE supports the adoption of the 2012 edition for the reasons outlined in this position statement.
New FDA Initiative Aims to Prevent Surgical Fires (October 17, 2011)
ASHE is one of several organizations partnering with the U.S. Food and Drug Administration (FDA) on a new initiative to prevent surgical fires. The Preventing Surgical Fires project aims to increase awareness of factors that contribute to these preventable fires and to promote the adoption of risk reduction strategies throughout the health care community. An estimated 550 to 650 surgical fires occur in the United States every year, and some cause serious injury, disfigurement, or death.
The FDA regulates drugs and devices that can contribute to surgical fires, including skin preparation agents, oxygen, lasers, and surgical drapes, and it reviews product labeling to make sure warnings of fire risk are included when appropriate. But the FDA says regulatory efforts alone are not enough to prevent surgical fires. The new initiative provides recommendations and information for health care professionals, hospitals, and patients.
ASHE Engineering and Compliance Director John Collins was part of the FDA group that created the initiative. Collins said surgical fires are well understood and can be prevented. “It’s a real simple problem,” he said. “It just keeps reoccurring because people don’t pay attention.” The initiative will shine a spotlight on the issue, hopefully reducing the number of surgical fires by sharing best practices and encouraging consistent education to staff on ways to prevent the fires, Collins said.
More information on the initiative can be found online at www.fda.gov/preventingsurgicalfires.
Joint ASHE, APIC, and SHEA Response to Electronic Faucet Technology (June 23, 2011)
Recent conflicting study results have illuminated the need for further assessment of sensor-regulated faucets to determine when their use is appropriate in health care facilities. A recent abstract from the Johns Hopkins Health System discussing research on their local experience has led to much media coverage of electronic faucet use and instigated a review of the state of the art by several professional organizations. Under the leadership of ASHE, the Association for Professionals in Infection Control and Epidemiology (APIC), the Society for Healthcare Epidemiology of America (SHEA), and the Facility Guidelines Institute (FGI), a stakeholders coalition has been formed with the goals of (1) increasing overall knowledge of biofilm in clinical settings; (2) gaining clinical and technical support to help assess infection control issues associated with manual and electronic faucets; and (3) gathering data on the use of faucets, particularly sensor-regulated faucets, in the health care environment. To learn more about the work of this coalition, read the joint ASHE–APIC–SHEA statement.
ASHE Members Contribute to NFPA Debate in Boston (June 15, 2011)
At the NFPA Technical Meeting in Boston June 14, debates ended with the acceptance by the NFPA membership of the 2012 edition of NFPA 99: Standard for Health Care Facilities. After six years of development, including one return of the document to committee, the draft 2012 edition was finally accepted with five amendments. Once the NFPA Standards Council issues these amendments (expected in August 2011), NFPA 99-2012 will officially be a code. Read the full ASHE Regulatory Advisory for details.
Public Proposal Period Opens for Health Care Design and Construction Guidelines (April 25, 2011)
The public proposal period to recommend updates to the nationally accepted Guidelines for Design and Construction of Health Care Facilities opened April 20, 2011. Architects, consulting engineers, administrators, facility managers, interior designers, medical professionals, and other interested parties are invited to submit proposals that suggest changes to the 2010 edition of the Guidelines until October 31, 2011. All proposals for change must be submitted through the electronic proposal system at www.fgiguidelines.net/proposals, hosted by the Facility Guidelines Institute (FGI). The 126-member, multidisciplinary 2014 Health Guidelines Revision Committee will review all proposals. Those that are accepted will be available for public review and comment in the draft 2014 Guidelines, scheduled to be released in 2012. For more information about the proposal period, please read the joint FGI-ASHE press release.
Included in the text open for revision is a new chapter with requirements for critical access hospitals. This material was prepared at the conclusion of the 2010 Guidelines revision cycle and posted on the FGI website as draft guidelines. At its meeting in April 2011, the 2014 HGRC voted to accept the chapter and make the text available for public proposals. This text can be downloaded from the FGI website.
Joint ASHE & APIC Statement on Recently Presented Electronic Faucet Research (April 11, 2011)
Recent news stories about the potential for a higher occurrence of Legionella spp. in electronic-eye faucets may have raised some concern among infection preventionists and clinical staff in many health care organizations. The information being publicized came from a limited investigation of water faucets conducted by the Johns Hopkins Hospital and presented at the 2011 Annual Scientific Meeting of the Society for Healthcare Epidemiology of America (SHEA) in Dallas on April 2, 2011 (see the Johns Hopkins Medicine press release for details).
In response to concerns raised about the use of electronic faucets in the Johns Hopkins report, ASHE and the Association for Professionals in Infection Control & Epidemiology (APIC) have released a joint statement offering some perspectives on the results of this study. The issue of infection control and prevention in relation to electronically controlled faucets has been raised in previous investigations, and manually operated faucets have also been found to harbor bacteria. No matter what types of faucets are used in a health care facility, infection prevention measures are needed to ensure water safety. ASHE and APIC both recommend that facilities begin any review of their plumbing fixtures with an infection control risk assessment. For more information, read the joint ASHE-APIC statement.
Use of Electronic-Eye Faucets in Health Care Facilities (April 7, 2011)
Recent news stories about the potential for a higher occurrence of Legionella spp. in electronic-eye faucets may be raising some concern among infection preventionists and clinical staff in many health care organizations. The information being publicized came from a limited investigation of water faucets conducted by the Johns Hopkins Hospital and presented at the 2011 Annual Scientific Meeting of the Society for Healthcare Epidemiology of America (SHEA) in Dallas on April 2, 2011. A link to the Johns Hopkins Medicine press release on the subject is provided in the full ASHE Regulatory Advisory.
In light of the passion health care staff members have for protecting patients from infection, there may be a rush to recommend removal of electronic-eye faucets from health care facilities. However, because the Johns Hopkins study found no actual infections or disease transmissions (the information about Legionella came simply from culturing of the faucets), ASHE is recommending that ASHE/AHA members await more information on the Johns Hopkins investigation before removing electronic-eye faucets. Making wholesale changes to faucets before more is known about the science of the investigation, its evidence has been peer reviewed, and experts have had a chance to develop a well-thought-out course of action could cause more harm than good.
ASHE and the Association for Professionals in Infection Control and Epidemiology (APIC) are working to prepare an article providing perspectives on the publicized Johns Hopkins Hospital study. Please watch for this article, which will be posted here on Monday, April 11. (Read the full ASHE Regulatory Advisory .)
An Important Opportunity to Influence Revision of NFPA 99 and NFPA 101 (March 29, 2011)
ASHE members are encouraged to attend the NFPA Technical Meeting June 14-15 in Boston. Revisions to NFPA 99: Health Care Facilities and NFPA 101: Life Safety Code® based on public input have been made, and the text for the 2012 edition of both these documents is nearly final. However, a number of significant issues remain on the table for consideration at the June meeting, making this gathering possibly the single most important NFPA meeting for health care members to attend in the past 10 years. Although it can be difficult to take time away from your facility, it is important to have health care advocates present at the upcoming NFPA Technical Meeting to vote on whether these and other important changes make it into the final document. For more information and details about attending the NFPA Technical Meeting, read the full ASHE Advocacy Alert .
ASHRAE/ASHE Standard 189.2P Advisory Public Review Draft Available (March 22, 2011)
The public review period for proposed ASHRAE /ASHE Standard 189.2P: Standard for the Design, Construction and Operation of Sustainable High-Performance Health Care Facilities has opened. The draft document is available for public review from March 18 through May 2, 2011, and can be accessed from the ASHRAE website.
Background (adapted from the foreword to 189.2P). As sustainability in the building design and construction environment has expanded from basic energy efficiency goals to the development of the USGBC LEED® program and the wide variety of standards, guidelines, codes, and programs available today, choosing and following a path to sustainability can be daunting. ASHRAE aimed to set a new course by developing ASHRAE Standard 189.1-2009: Standard for the Design of High-Performance Green Buildings, the first document on the subject that jurisdictions can adopt to provide minimum design and construction requirements for sustainability.
Health care facilities are often the largest, most energy-intensive buildings in a community, and their leaders recognize that saving energy and operating costs is an opportunity to reflect smart decision-making, care, and stewardship of the environment as well as fiscal practicality. However, in a competitive, regulated market in a difficult economic climate, health care organizations have limited funds to undertake sustainability efforts. As well, the special requirements of a health care facility's use often dictate needs that diverge from those of other facility types.
ASHRAE is seeking to address sustainability for health care facilities in a document distinct from ASHRAE Standard 189.1. The work already accomplished by that standard has provided a solid framework for this new standard. The development of Standard 189.2 is a collaborative effort between ASHRAE and ASHE. How to comment. The project committee hopes interested parties from all segments of the health care community and the general public will provide constructive comments on the draft during the advisory public review. ASHRAE only accepts comments submitted through its online comment system.
Pending Revision to CMS S&C Letter on Occupancy Classifications (February 14, 2011)
On December 17, 2010, CMS issued a Survey and Certification letter updating its occupancy classifications to ensure alignment with the 2000 edition of NFPA 101: Life Safety Code. The content of this update (S&C 11-05-LSC) engendered a lot of questions about the potential impact this “clarification” could have on clinics and medical office buildings belonging to ASHE members' organizations. As of February 14, 2011, CMS has told ASHE that “a revision is pending within CMS which should address most of the concerns of the health care field.” For more information, read the full ASHE Regulatory Advisory .
Joint Commission Adopts 2010 Guidelines for Design and Construction of Health Care Facilities (January 3, 2011)
Effective January 1, 2011, the Joint Commission updated its Standard EC.02.06.05, which addresses the design and construction of health care facilities. The standard formerly referred users to the 2001 Guidelines for Design and Construction of Hospitals and Health Care Facilities for design criteria for new construction as well as alterations and renovations. In its 2011 accreditation manual for hospitals, the Joint Commission announced in the December 2010 issue of its publication Environment of Care® News, the requirement refers to the more current 2010 Guidelines for Design and Construction of Health Care Facilities.
In EP 1 of the standard, organizations are required to use either state rules and regulations or the Guidelines in their design and construction efforts. According to John Fishbeck, RA, associate director of the Division of Standards and Survey Methods at the Joint Commission, the reference update from the 2001 edition to the 2010 edition "does not constitute a revision to the main intent of this element of performance." Rather, says Fishbeck, the change "is just updating the 2001 edition of the Guidelines within the standard. As before, organizations will also have the option of using state rules and regulations as well."
Fishbeck further pointed out that projects that entered "the design phase before January 1, 2011, can continue to use the 2001 Guidelines, but any new designs initiated after January 1, 2011, need to follow the 2010 Guidelines or the state rules and regulations relevant to the organization."