2014 FGI Safety Risk Assessment (SRA)
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1 2014 FGI Safety Risk Assessment (SRA) Overview DOH / CRS Expectations Local example: Harborview Medical Center Center for Health Design Toolkit
2 SRA: FGI Requirement (PDCC) All health care facility projects shall be designed and constructed to facilitate the safe delivery of care To support this goal, an interdisciplinary team shall develop a safety risk assessment SRA Components The SRA components identified in Table (Safety Risk Assessment Components) shall be required.
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4 SRA: Appendix Table A1.2a
5 SRA: Intent The SRA describes an owner driven process that provides facilities a means to proactively assess and implement built environment solutions to mitigate potential risks and hazards during building renovation or construction The design team may lead the conversation and document this process, provided the facility accepts the content, recommendations, and decisions as their own.
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7 SRA: DOH / CRS Expectations Licensing rules seek to ensure that healthcare facilities: Discuss the underlying conditions of the built environment that can lead to harm Document the results and recommendations of these conversations Integrate the recommendations into the construction documents and built environment
8 SRA: CRS Review As part of the plan review process CRS will review the documentation and how the ideas are integrated into the construction documents There is no single format for this process though there are tools available. The FGI provides common terminology and document structure.
9 SRA: Concept and Process Feedback People Implement Conditions Design Evaluate Recommend
10 SRA: Content and Structure SRA Components Infection Control Risk Assessment (ICRA) Patient Handling and Movement Assessment (PHAMA) Patient Fall Prevention Medication Safety Behavioral and Mental Health Patient Immobility Security Risks
11 SRA: Components Infection Control: ICRA and ICRMR Design recommendations generated by a facility operational infection control risk assessment Infection control risk mitigation recommendations (ICRMRs) specific to risks represented by planned construction or facility modifications
12 SRA: FGI Requirements
13 SRA: Components ICRA Elements apparent when using the space ICRMRs Elements and measures necessary to undertake construction in a functioning hospital
14 SRA: Components Patient Handling and Movement Assessment Develop a patient handling, movement, and mobility needs assessment to identify appropriate patient handling and movement equipment Provide design guidance which may include space and structural requirements
15 SRA: Components PHAMA Design Considerations: Structural capacity and electrical service Clear floor area Destination points for ambulating patients Door and opening sizes Flooring surfaces Equipment Storage
16 SRA: Components Patient Fall Prevention Identify fall risk locations and in new and renovation projects Handrails Toilet room doors Location of toilet Lift systems
17 SRA: Components Medication Safety (Zones) Number Location Design Medication Preparation Room Self-contained medication dispensing unit Automated medication dispensing station Other approved by AHJ
18 SRA: Components Behavioral and Mental Health Identify areas that will serve patients at risk of mental health injury and suicide Identify mitigating features for the identified at-risk locations
19 SRA: Components Patient Immobility Decrease the risk of hospital-acquired disabilities caused by lack of mobility Design can encourage and enable patients to remain active and support rehabilitation efforts
20 SRA: Components Security Risks Circulation Vulnerable populations Sensitive areas Emergency management Resource: International Association for Healthcare Security and Safety (IAHSS) design guide
21 SRA: Components Facility/Context Specific Elements FGI identifies required elements based on adverse incident data Each project presents unique challenges and opportunities for improvement The SRA is a means to initiate a systemic improvement process
22 SRA: Assessment Identify the issue. Develop arguments that support the proposed process or issue. Develop arguments that oppose the proposed process or issue. Evaluate both arguments. Reach a conclusion. Document the process. Monitor and reassess the conclusion
23 SRA: Summary Who: Facilities, Designers and Consultants, DOH What: Licensing requirement constructed to ensure facilities develop and implement built environment solutions to potential risks and hazards Why: Improved outcomes through proactive design How: Discussion, documentation, implementation
24 SRA: DOH /CRS Expectations Discuss All pertinent elements within the scope of work ProvideDocumentation of considerations and recommendations for review Implement Recommendations (or document why not)
25 Resources A Brief Guide: Using the Safety Risk Assessment Tool in Healthcare Facility Design & Construction Safety Risk Assessment Toolkit for Health Care Facility Environments General FGI Resources page
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