(2/14/2022)

Regulations and compliance standards are critical in healthcare. They improve patient safety, monitor care quality and hold healthcare professionals accountable to their patients and communities. Unsurprisingly, COVID-19 presented new operational and safety challenges to healthcare facilities that tested their abilities to pivot from entrenched standards to rapidly changing guidelines. Medxcel’s facilities fared well in the face of pandemic-related compliance changes because we go beyond the basics when it comes to keeping patients, staff and visitors safe.
 

0461-Inspector-with-Manager.jpgBeyond the Basics #1: Why
Compliance standards are not arbitrary. There’s a reason each and every one has been implemented at a federal, state or local level. However, it can be difficult to enforce those standards if your team doesn’t understand the “why” behind them. “Do it because I said so,” doesn’t work for anyone. Educate your team about the reasons behind essential compliance standards to reinforce their importance. This leads to both better overall compliance and underlines why these guidelines are important and will help staff understand the methodology of safety.
This is particularly helpful when faced with multiple, conflicting compliance regulatory requirements. When dealing with local, state and federal regulatory requirements for your facility, associates who understand the “why” behind compliance know that they must always follow the most stringent regulatory requirements. Not only will this ensure the facility is not in violation of any regulations that fall in your jurisdiction, but it also keeps your facility compliant and functioning at the highest standards.

Beyond the Basics #2: Proactivity
The key to establishing a successful compliance program is understanding the demands of your facility. Aggregate data into one place to see where issues lie. The next step: use the data you collected and analyze it to proactively find functions to optimize and issues to address. Do high-risk rooms, such as ORs, maintain proper pressure differentials to adjoining space? Are potential ligature risks regularly assessed? These are questions that facilities should ask themselves early and often. There needs to be an answer for a potential problem before it becomes an actual problem. Early on in the pandemic, we understood that COVID-19 was an airborne-transmitted virus. Knowing this, we knew that managing the air would be important to reducing spread of the virus within facilities. Quickly, Medxcel implemented air management technology safeguards into our facilities. This was not a compliance requirement, but rather a proactive effort to go beyond compliance standards for the safety of our patients and staff during a crisis.
Another proactive effort: your facility should be making strides to move building automation system accessibility to mobile devices. Broad accessibility is essential, whether associates are on-site or not.

Beyond the Basics #3: Adjust Plans When Necessary
It is important to note that compliance standards set the baseline of requirements. Good facilities work to adjust their plans to mitigate risk even if that means performing above the set standard. For example, TJC surveys have historically found the most likely “not compliant” areas are related to a facility’s systems such as those for extinguishing fires and protecting individuals from fire and smoke hazards. In a perfect world, facilities would ensure all these systems are working properly at all times. In the chance that one is not performing as expected, TJC notes a timeframe in which a facility should remediate the issue. As a good facility should exceed these standards, fixing issues should be prioritized and completed well before the deadline.
TJC standards can change and it is essential that your team stays up to date with all compliance standards. When locating weak points in your facility, look for feedback from people in the field. Often, the people who notice weaknesses first are the people working most closely in these areas and they may have the best solutions for addressing them.
At the different points throughout this pandemic, facilities of all sizes and in every location have faced a slew of distinct issues that needed to be addressed. The facilities themselves, as well as their operating structures, had to undergo adjustments to meet new – and often changing – guidelines. While each site faces its own unique set of challenges, proactive responsiveness and surpassing compliance requirements have proven invaluable in ensuring safe and efficient operations in unpredictable times.

As the largest sole provider of healthcare facilities services in the U.S., Medxcel is dedicated to creating a safe healing environment in the hospitals we serve. We understand that staying ahead of compliance regulations, ligature risks, life safety drawings and mechanical, electrical and plumbing concerns is a full-time job, and many hospitals lack the additional resources and staff to dedicate time to this. If you are looking for assistance with your own compliance program, contact us at info@medxcel.com, call 855-633-9235 or visit www.medxcel.com/services/consulting.