It has been a challenge for many healthcare organizations to keep up with the increasingly stringent ventilation requirements imposed by CMS and accrediting agencies for critical and non-critical spaces within their facilities. Sure, we monitor our ORs, but how do we keep track of what rooms we have and their use (especially when staff continuously convert them to storage spaces) - let alone ensure we are maintaining the proper pressure differentials or humidity to be compliant with Standards such as TJC's EC.02.05.01 EP 15 & EP 16?
Learn how one 6 million s.f. academic health center turned its program around, and receive tools to help you do the same: from creating detailed room inventories with relevant ventilation details, to changing testing frequencies and procedures, utilizing a variety of monitoring systems, implementing a program to support sensitive spaces in offsite locations, and updating policies on ventilation alarm response protocols.
State the Joint Commission requirements regarding room ventilation.
Identify critical and non-critical rooms in a facility.
Assess spaces based on FGI Guidelines.
Evaluate spaces for appropriate preventive maintenance and testing frequencies.