Let’s Get Real! Trends and Directives That Don’t Really Work E-23
Barbara Dellinger, MA, Teri Lura Bennett , RN Helen Lanes, CHID, IIDA, Andrea V Hyde , MDCID, FIIDA, CHID, EDAC, MDCID, CHID IIDA EDAC NIHQ NCIDQ CHID, NCIDQ NCIDQ Lead Interior Designer Interior Design Project Senior Project Director of Interior Manager Manager - Interiors Design & Research Johns Hopkins Health Lanes Consulting Adventist Health System, Stanford Health Care System Arlington VA Baltimore, MD Palo Alto, CA Rockville, MD 410-955-5411 202-345-1241 240-826-6066 650-497-2400 Helenlanes@yahoo.com tbennet2@jhmi.edu BDelling@adventisthealthcare.com ahyde@stanfordhealthcare.org
Continuing Education Information Nursing CEU - 1 Nursing Unit Credit EDAC - Self submit for 1 EDAC Credit AIA – Self submit for 1 hour credit IDCEC – Self submit for 1 hour credit
Exam ine directives from … The Joint Com m ission, Facility Guidelines I nstitute, as w ell as Current Teri Lura Bennett Trends. RN CHI D CI D I I DA EDAC NI HD Lead I nterior Designer, Johns Hopkins Health System s
Make it easy for people to do the right thing…design for the Real W orld !
Valuable Resources or Boogeymen? FGI TJC LEED HHI HCAPHS HHI CDC EPA
Trick question, its both …because, its com plicated They can be an alphabet soup of Acronyms, all with their own primary directives; often at cross purposes, & confusing at the very least!
TJC aka The Joint Commission; Behavioral Health Units receiving citations for furniture that is not anti-ligature, i.e. has a ligature point with an 18 inch drop! Challenge? Furniture is purported to be “Behavioral Health” appropriate but may not actually be anti-ligature!
W hich Furniture is Anti-ligature?
W ho decides? Bottom Line is, You do! ..or rather the entire clinical team does… . The Healthcare Interior Designer in collaboration with Clinical staff, & entire Risk Assessment team need to evaluate actual samples and make your own assessment! Clinical team, Facilities, Safety, Hospital-JC team all need to assess items for our locations!
Lesson: You can’t take anyone's w ord for it, you m ust evaluate the risk for yourself!
FGI - CDC – EPA – in conflict? FGI recommends carpet in a NICU, for the acoustic benefits… . The Challenge? There is no CDC - EPA approved cleaning regimen for removing blood-borne pathogens from carpet!
The Challenge? There is no CDC - EPA approved cleaning regimen for removing blood-borne pathogens from carpet! CDC recommends replacing it!! Really? Blood-borne pathogens in our NICU flooring? I don’t think so!
FGI - CDC - EPA Our solution in NICU? Acoustic backed rubber flooring , & resilient sheet goods with recycled rubber backing. Charting Station alcoves, with Wall, Ceiling & Lighting treatments designed to reduce noise transmission.
Existing Rubber floor with acoustic background, had issues of adhesion loss, requiring patching & replacing, with persistent soiling. Mfr is an active partner to help solve problems. Our clinical partners are enthusiastic supporters of rubber flooring with acoustic backing. Currently exploring steam cleaning process.
Wood finish worn off by healthcare cleaning paradigm, exposing open pore wood, … … … imagine the bacteria on this wood armrest!
In November of 2016, the CDC ruled against using antimicrobials in patient rooms and patient care areas. … & yet… .. Manufacturers continue to invest time and resources into using antimicrobial finishes!
LEED – EPA – HHI & HCAPHS Durable Coated Fabrics – Use Non-PVC Polyurethane; & get rid of Vinyl. Resulting in… - upholstery failures from real world use, - expensive to replace - lower HCAPHS Scores
Specified 2014 We were going for “sustainable”.
& another non-PVC Polyurethane
Major donor funding, with directive to use fabrics with special treatments to provide cleanable, durable, moisture-proof woven textile upholstery selections. Original furniture budget of several million dollars.
It looked great for the photos, & on Day 1…
… but on Day 201…
After herculean efforts by our environmental services team to stay ahead of this problem we still had furniture pulled from service for permanent soiling, staining, puddling, found abandoned in BOH elevator lobbies, and basement corridors. The decision was made to reupholster all waiting and patient room furniture...
Durable Coated Fabric Task Force HCD 2018 Presentation available on AAHID web site: https://aahid.org/wp-content/uploads/2019/02/durable- coated-fabrics-ppt-2018-hcd.pdf
Designers, Facilities, EVC, Contractor, & Manufacturer were all active partners to solve the problem! No Finger pointing allowed!
What can we do? Encourage all interior designers to discuss this with their peers, clients, consultants… We don’t have all the answers yet, but can all partner to help find the solutions! 2/21/2019 29
Do the best you can until you know better. Then w hen you know , do better. Maya Angelo
How to make yourself indispensable to a Healthcare System. Helen Lanes CHI D I I DA NCI DQ I nterior Design Project Manager In-house or contracted Interior Lanes Consulting Designer & Clinical Providers… Arlington VA What is your differentiator?
Outpatient Cancer Center – with Research
Health System task groups • Administration (vision) • Clinicians (needs) • Infection Prevention • Environmental Services • Safety/ Security • Facilities (maintenance) All with their own primary directives and often at cross purposes; confusing!
Don’t under value your com petence • Healthcare clinicians don’t know, what they don’t know • Clinicians are looking at you as the expert to present solutions to their problems and not be the “order taker” • Research driven data • P .O.E’s • Disrupt the status quo • Timing for solutions • Don’t loose track of the big picture. Every LI TTLE detail has a BI G im pact on the task groups
• Administration (vision) • Clinicians (needs) • Infection Prevention • Environmental Services, • Safety/ Security • Facilities (maintenance) You are here to make “their job better”
• Administration (vision) • Clinicians (needs) • Infection Prevention • Environmental Services, • Safety/ Security • Facilities (maintenance) You are here to make “their job better”
• Administration (vision) • Clinicians (needs) • Infection Prevention • Environmental Services, • Safety/ Security • Facilities (maintenance) You are here to make “their job better”
Interior Design Guidelines
I nterior Design tim eline: Schem atic Design to Design Developm ent • Interior Finishes and Furniture Standards • Issues that need solutions • Architectural Specification guideline supplements and details 3 0 % -6 0 % Progress Docum ents • System’s Lesson’s Learned • Interior Finishes, materials and furnishings discussion – expertise on technologies and proven track records • Review recommended “new” technologies and solutions – buy-in required
I nterior Design tim eline: 9 0 % Progress Docum ents • Review interior finishes and new technologies integration • Integration of supplemental architectural specifications Perm it set Docum ents • Details, details, details… . Ensure they are thought through and integrated Contract Adm inistration and Quality Assurance • Details, details, details… . Follow them through to the end
You are the expert and when you step up to the plate, the system learns that they can’t live without you…
How to adapt system-wide design standards to regulatory standards, befitting the quality & life expectancy of the project Andrea V Hyde, MDCID, CHID, NCIDQ Senior Project Manager - Interiors Stanford Health Care Palo Alto, CA
What do you really-really want? • What does TJC, CMS, FGI & other regulators really want from Healthcare operations and their facilities? – Always Best to Go Directly to the Most Current Source Info…
What do you really-really want? TJC – 2018 National Patient safety goals for Hospitals… TJC Goals – Purpose to improve patient safety – help us focus on the current problems and how to solve them… https://www.jointcommission.org/a ssets/1/6/2018_HAP_NPSG_goals_fi nal.pdf
What do you really-really want? TJC – 2018 National Patient safety goals for Hospitals… – Goal 1 - Improve the accuracy of patient identification – Goal 2 - Improve the effectiveness of communication among caregivers – Goal 3 - Improve the safety of using medications
What do you really-really want? TJC – 2018 National Patient safety goals for Hospitals… – Goal 4 - Use alarms safely – Goal 5 - Reduce the risk of health care–associated infections. – Goal 6 - Identify safety risks inherent in specific area of use patient populations – Goal 7 - Prevent mistakes in surgery
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