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Hard Facilities Management And Infection Prevention

How Does Hard Facilities Management Impact Infection Prevention and Prioritize Patient Safety?

Healthcare-associated infections (HAIs) are an avoidable nightmare. While you may have taken many measures to prevent them, there is an often-overlooked risk factor right in front of your eyes — the hospital building.

Hard facilities management (FM) refers to the physical structure of your hospital. It’s the parts of your building that can’t be removed or altered without construction. It may not get much attention, but it plays an undeniable role in patient health.

HFM includes services such as:

  • Heating
  • Lighting and electrical
  • Plumbing
  • Fire safety systems
  • Air conditioning and HVAC
  • Mechanical


How Common Are Healthcare-Associated Infections? Roughly 1 in 31 patients in the US has at least one healthcare-associated infection on any given day. Source: Centers for Disease Control and Prevention


There has been significant progress when it comes to preventing healthcare-associated infections, but there are still many preventative measures that can be taken within your hospital building.

Brooke Hossfeld, MPH, CIC, MLS (ASCP)CM, Infection Prevention Specialist at Sodexo Healthcare, answers your questions about how hard facilities management can impact infection prevention within a hospital setting.


What are some of the major risks regarding infection and hard facilities management?

The major risks with hard facilities management and infection control are typically structural in nature and revolve around plumbing, ventilation, and heating/cooling.

The average hospital structure is old and built at a time when building codes weren’t as stringent as they are today. Even more, codes dealing with patient and life safety didn’t exist. When you can’t control the structural environment of a hospital, it can lead to potential risks, such as improper water filtration, poor air circulation, and a host of other issues.

When hospitals don’t follow important regulations that are put into place, patients can be exposed to unpurified water that may have microbes or air that may have dust, spores, and other allergens — all of which can cause illness or other medical reactions. For example, without proper airflow checks for patients in isolation, they can be exposed to potentially infectious diseases, such as tuberculosis.


How does Sodexo’s facilities management prevent infections that come with these risks to keep patients safe?

Facilities that utilize Sodexo for facilities management can be assured that our staff has been trained in infection prevention strategies, preventing environmental transmission, and the basic environment of care and building management.

We do routine tests including culturing of air, water, and surfaces of certain areas, such as a pharmacy compounding or sterile medication areas. We also maintain all proper airflow circulation and ensure ductwork stays clean and free from obstructions.

Of course, there are many other important routine tests besides those to prevent infection, including checking fire extinguishers, sprinkler systems, fire doors, and alarms. These play just as important of a role in patient safety.

When cleaning and caring for a healthcare environment, our staff uses products that utilize the hospital’s filtered water, maintain proper water and air temperatures, and follow all standards and codes required for the environment they will be working in.


What kinds of technology are utilized in the infection control process?

There are several important standards that need to be followed for any routine testing of environmental factors — mainly air, surfaces, and water.

Water and air are collected and sent to third-party verifiers, who perform culture and air quality testing to make sure there is no microbial growth found in either substance, as allowable amounts are often very limited. If any values outside of the acceptable range are found, we begin remediation efforts to protect patients. For instance, plumbing may be flushed, new air filters may be put in place, or airflow may be changed.

All reports are shared between facilities management and infection control to maintain consistent dialogue and collaboration between the two teams.


When you begin working with a new hospital, what are your first major considerations?

Anytime a construction project is planned for a healthcare facility, a few items need to be completed before any work can begin.

First, the infection control team and the facility manager complete an Infection Control Risk Assessment (ICRA). Both teams must walk the proposed construction site and discuss all work, including air and water flow, patient and staff movement, dust, debris, and worker entry and exit. Finally, the project will be graded.

We also consider the age of the building. Often, older buildings have had the same plumbing and HVAC systems in place since the initial construction.

Any major renovations or additions will also be reviewed to make sure the proper precautions were put into place to block water and air circulation from flowing through construction areas. Finally, we need to ensure that all systems were flushed, cleared, and tested before they’re put back into use for patients.


What kind of regulations exist that facilities managers at hospitals must be aware of?

There are a number of codes that fall under many different regulating agencies — and a good facility manager needs to be aware of them all.

In addition to the routine checks for water and air, there are other factors that must be checked and maintained consistently. These include fire safety systems checks, pharmacy compounding surface cultures, plumbing circulations, and routine flushings.

Regulations often overlap when it comes to the hospital environment, environment of care, and infection control. It’s key to have a good relationship with the infection control team, attend all infection control committee meetings, and keep rolling schedules for deadlines so that nothing is overlooked.


How does a facility manager work with construction companies during times of hospital renovation?

The infection control and facility managers are responsible for walking the construction site daily to ensure the necessary precautions for the project are in place and followed by everyone in the area. Depending on the grade, certain precautions are put into place during the construction process, such as barriers, HEPA filters, or closing plumbing valves.

Collaboration is key. Maintaining a good working partnership and involving each other in committee meetings and projects will ensure that all regulations are being followed and the hospital is in compliance codes and environmental testing — all of which ensure patient safety.

Contact us to know more about how to keep your patients safe using hard facilities management.

June 30, 2020

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